Tuberculosis in chronic renal failure in Jeddah

Immunocomprised patients with chronic renal failure haemodialysis have been reported to be at increased risk of developing tuberculosis. The purpose of this study was to monitor the development of tuberculosis in patients with chronic renal failure that have not yet been dialysed, presenting at the Renal Clinic of the King Khalid National Guard Hospital, Jeddah, Saudi Arabia.

Eighty patients with chronic renal failure were followed up for a period of 3 years and were carefully monitored for the development of tuberculosis. Mantoux test, chest radiograph and sputum examinations were performed at the beginning of the study and every 6 months thereafter.

At the end of 3 years, eight out of 80 patients (10%) had developed tuberculosis, confirming the high incidence of tuberculosis in this group of patients. All the eight patients who developed tuberculosis before being started on dialysis had relatively low creatinine clearances. No particular underlying renal disease was associated with the development of tuberculosis. Four patients developed pulmonary tuberculosis, two renal tuberculosis and one each cervical tuberculous lymphadenitis and tuberculous meningitis. All patients responded satisfactorily to anti-tuberculosis therapy, as diagnosis was established early.

Routine screening for tuberculosis is recommended for patients with chronic renal failure presenting at Renal Units, and tuberculosis chemoprophylaxis should be considered for those undergoing haemodialysis, particularly in countries with a high incidence of tuberculosis.