[Problems of tuberculosis patients under dialysis in Tama area, Tokyo]

Patients undergoing renal dialysis (dialysis patients) are generally known to have a higher risk of tuberculosis (TB). In order to address this problem effectively, analyses were made of the characteristics of active TB patients under dialysis in the Tama Area of Tokyo.

Dialysis patients were selected from the list of TB patients who were newly registered at seven public health centers in the Tama Area between 2007 and 2009. The incidence rate of TB in dialysis patients was calculated. Their personal profiles such as age, affected organs, results of sputum smear, modes of case detection, and delay in case detection, were reviewed in comparison with those in TB patients not undergoing dialysis.

Dialysis patients had 8.34 times higher TB incidence rate than non-dialysis subjects. They were more likely to have extra-pulmonary TB. The dialysis patients visited doctors sooner after the appearance of symptoms, which resulted in a higher proportion of smear-negative TB among them. Periodic chest X-ray examination at dialysis clinics played an important role in early TB diagnosis.

It is important for dialysis clinics to maintain a high index of TB, since dialysis patients are at a higher risk of TB. In addition, careful attention should be paid to a patient's past history of TB infection, as well as to the findings of periodic chest X-ray examinations.