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Tuberculosis in haemodialysis patients: A single centre experience
T Manmadha Rao1, R Ram, G Swarnalatha
1Department of Nephrology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India.
Indian Journal of Nephrology
|September 20, 2013
Summary
Tuberculosis is common in hemodialysis patients, affecting 10.5%. Key risk factors include male gender, diabetes, and longer dialysis duration. Early identification and management are crucial for this vulnerable population.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- Maintenance hemodialysis patients are at increased risk for infections.
- Tuberculosis (TB) poses a significant threat to immunocompromised individuals, including those on dialysis.
Purpose of the Study:
- To determine the incidence and risk factors of tuberculosis in new patients initiating maintenance hemodialysis.
- To identify specific organ involvement patterns of TB in this cohort.
Main Methods:
- Prospective follow-up of 1237 new hemodialysis patients over a 10-year period (2000-2010).
- Diagnosis of tuberculosis based on clinical presentation and organ involvement.
- Univariate analysis to identify significant risk factors.
Main Results:
- 131 patients (10.5%) were diagnosed with tuberculosis post-hemodialysis initiation.
- The incidence of tuberculosis was 105.9 per 1000 patient-years.
- Significant risk factors identified: male gender, diabetes mellitus, prior TB history, mining occupation, low serum albumin, dialysis duration >24 months, and unemployment.
Conclusions:
- Hemodialysis patients have a high incidence of tuberculosis.
- Several demographic, clinical, and socioeconomic factors increase TB risk in this population.
- Targeted screening and preventive strategies are warranted for high-risk hemodialysis patients.
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