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[Tuberculosis in patients with chronic kidney failure].
M Válek1, S Sulková, A Slováková
1Interní oddĕlení Strahov 1. LF UK a VFN, Praha. m.valek@seznam.cz
Casopis Lekaru Ceskych
|August 19, 2003
Summary
Tuberculosis (TB) is more common in dialysis patients, with extrapulmonary forms prevalent. Early diagnosis is challenging due to non-specific symptoms masked by other conditions.
Area of Science:
- Nephrology
- Infectious Diseases
- Pathology
Background:
- Retrospective analysis of tuberculosis (TB) incidence in end-stage renal disease (ESRD) patients undergoing dialysis.
- Study period: 1991-2000 at General University Hospital, Prague.
- Included deceased patients who underwent autopsy.
Observation:
- Active TB identified in 4% (11 of 275) of dialysis patients.
- Higher TB risk observed in dialysis patients compared to the general population.
- TB diagnosed before death in only 5 cases; 6 cases discovered during autopsy.
Findings:
- Extrapulmonary TB predominated (81.8%) in dialysis patients, unlike the non-dialyzed population (75% pulmonary).
- Miliary TB was the most common form, seen in 72.7% of cases.
- Non-specific TB symptoms were often masked by co-morbidities in ESRD patients.
Implications:
- TB must be considered in the differential diagnosis of dialysis patients.
- Diagnostic strategies should include both pulmonary and extrapulmonary TB.
- Improved diagnostic approaches are needed for early TB detection in ESRD patients.