Tuberculosis in chronic renal failure in Jeddah

The incidence of tuberculosis is still high in many developing countries and immunocompromised patients with chronic renal failure requiring haemodialysis have been reported to be at increased risk of developing tuberculosis. In this study 80 patients with chronic renal failure were followed up for a period of three years and were carefully monitored for the development of tuberculosis. Mantoux test, chest radiograph and sputum were performed at the beginning of the study and every six months thereafter. At the end of the study period, 8 (10%) of the patients had developed tuberculosis, confirming the high incidence of tuberculosis in this group of patients. No particular underlying renal disease was associated with the development of tuberculosis. Four patients developed pulmonary tuberculosis, 2 renal tuberculosis and one each with cervical tuberculous lymphadenitis and tuberculous meningitis. All patients responded satisfactorily to anti-tuberculosis therapy as diagnosis was established early. The delayed recognition of tuberculosis and therefore a delay in the initiation of effective treatment is not only detrimental to the patient but also results in a potentially profound impact on public health. We recommend routine screening for tuberculosis in patients with chronic renal failure presenting at Renal Units and tuberculosis chemoprophylaxis for those undergoing haemodialysis, particularly in countries with high incidence of tuberculosis.