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Tuberculosis in patients undergoing maintenance hemodialysis
The American Journal of Medicine
|October 1, 1979
Summary
Tuberculosis (TB) is 10 times more common in hemodialysis patients. Early diagnosis and treatment are crucial for survival in these high-risk individuals.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- Maintenance hemodialysis patients face a significantly higher risk of tuberculosis (TB).
- The incidence of TB in this population is approximately 10 times greater than in the general population.
Observation:
- Dialysis-associated TB presents with non-specific symptoms like fever, anorexia, weight loss, and hepatomegaly.
- Ascites was observed in 50% of patients, and a recent positive tuberculin skin test in 5 out of 8.
- Tuberculosis was predominantly extrapulmonary (7/8 cases), leading to diagnostic delays.
Findings:
- Extrapulmonary TB in hemodialysis patients often presents insidiously, complicating early diagnosis.
- Delayed diagnosis and treatment initiation correlated with increased overall mortality (37.5%).
Implications:
- Antituberculous therapy should be considered in dialysis patients presenting with unexplained fever, anorexia, weight loss, or hepatomegaly, especially in endemic areas.
- Increased surveillance and awareness are necessary for TB detection in hemodialysis units.