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Tuberculosis and chronic renal disease.

Magdi M Hussein1, Jaap M Mooij, Haysam Roujouleh

  • 1Department of Nephrology and Dialysis, Al Hada Armed Forces Hospital, TAIF, Saudi Arabia. magdihussein@hotmail.com

Seminars in Dialysis
|January 22, 2003
PubMed
Summary

Patients with chronic kidney disease on dialysis face a significantly higher risk of tuberculosis (TB). Early diagnosis and treatment are crucial, as symptoms can be nonspecific and extrapulmonary TB is common.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Pulmonology

Background:

  • Patients with chronic renal failure (CRF) and on dialysis exhibit a markedly elevated risk of tuberculosis (TB), ranging from 6.9- to 52.5-fold compared to the general population.
  • TB presentation in renal patients is often subtle, mimicking uremic symptoms, with a predilection for extrapulmonary sites like lymphadenitis and peritonitis.

Purpose of the Study:

  • To highlight the increased risk and atypical presentation of TB in dialysis patients.
  • To emphasize the importance of early diagnosis and appropriate management strategies for TB in this vulnerable population.

Main Methods:

  • Review of clinical presentations and epidemiological data concerning TB in patients with chronic renal failure on dialysis.
  • Analysis of diagnostic challenges and treatment outcomes.

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Main Results:

  • Tuberculous peritonitis accounts for a substantial proportion (37%) of TB cases in continuous ambulatory peritoneal dialysis (CAPD) patients.
  • Extrapulmonary TB is frequently observed, often presenting with nonspecific symptoms such as anorexia, fever, and weight loss.

Conclusions:

  • Renal physicians must consider TB in the differential diagnosis of dialysis patients with nonspecific symptoms.
  • Prompt diagnosis, potentially including empirical anti-TB treatment if suspicion is high, and prophylaxis for at-risk individuals are essential for improved outcomes.