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Epidemiological, and management challenges in tuberculosis with chronic kidney disease
Shubham Chandra1, Thomas Vadakkan Devassy2
1Department of Pulmonary Medicine, Amala Institute of Medical Sciences(AIMS), India.
Background:
Patients with chronic kidney disease (CKD) are more vulnerable to tuberculosis (TB) because of weakened immune systems, which is a serious health risk, especially in low-to-middle-income nations.
Epidemiology:
CKD patients have a 6.9 to 52.5 times higher risk of developing TB, with dialysis patients at even greater risk.
Pathogenesis:
Impaired cell-mediated immunity, malnutrition, Vitamin-D deficiency, and Zinc deficiency contribute to TB susceptibility in CKD patients.
Diagnostic Challenges:
Atypical symptoms, nonspecific presentation, and limited diagnostic tools hinder TB diagnosis in CKD patients.
Management:
Collaborative care and tailored treatment are essential. Anti-TB therapy requires dosing adjustments, careful monitoring, and consideration of comorbid conditions.
Conclusion:
TB in CKD patients presents a complex clinical picture, requiring heightened awareness and multidisciplinary collaboration. Further research is needed to develop CKD-specific TB screening tools, optimal treatment regimens, and improved understanding of TB-CKD pathophysiology.
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