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Tuberculosis in patients undergoing maintenance dialysis.

M M Hussein¹, N Bakir, H Roujouleh

¹Department of Nephrology and Dialysis, Al Hada Armed Forces, Taif, Saudi Arabia.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association

|January 2, 2013

Summary

Tuberculosis (TB) affects 11% of maintenance dialysis patients, often presenting insidiously with extrapulmonary disease. Early diagnosis and treatment lead to excellent survival rates and no recurrence in this vulnerable population.

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Area of Science:

Nephrology
Infectious Diseases
Public Health

Background:

Maintenance dialysis patients face unique health challenges.
Tuberculosis (TB) is a significant concern in immunocompromised populations.
Previous studies reported high mortality for TB in dialysis patients.

Purpose of the Study:

To determine the incidence of tuberculosis in patients undergoing maintenance dialysis.
To characterize the clinical presentation and outcomes of tuberculosis in this cohort.
To assess the prognosis of tuberculosis in dialysis patients.

Main Methods:

Retrospective analysis of 205 patients on maintenance dialysis.
Diagnosis of tuberculosis confirmed through clinical and microbiological findings.
Clinical data collection included symptoms, presentation sites, and treatment outcomes.

Main Results:

Tuberculosis incidence was 11% (23/205 patients), predominantly in females (74%).
Extrapulmonary TB (78%) was common, with tuberculous lymphadenitis (55%) and peritoneal involvement (16%) being most frequent.
Pulmonary TB occurred in 21.7%, often with pleural effusions. Disease onset was typically around 1 year after starting dialysis.

Conclusions:

Dialysis patients exhibit an increased incidence of tuberculosis with atypical presentations.
Early diagnosis and prompt therapy are crucial for favorable outcomes.
Awareness of these factors leads to a good prognosis, contrasting with earlier high-mortality reports.