[Tuberculosis--an increasing risk for patients treated with long-term hemodialysis]

In the recent years an increase in the incidence of tuberculosis (TB) has been observed world-wide, including Poland. In the Department of Nephrology of Gdańsk School of Medicine, an increase in the incidence of TB has been observed among patients undergoing maintenance hemodialysis (HD). The aim of this work was to analyse the natural history of TB infection in this group of patients. Over the last seven years TB was diagnosed in 9 patients (5 female, 4 male) out of 171 patients on HD (5.2%). Seven of those were diagnosed in the last three years. The average age of patients with TB was 47.2 years. In three patients the clinical symptoms of TB has appeared during the first year of hemodialysis treatment (average 5.6 months), in the rest the mean period of dialysis before the TB diagnosis was 60 months. The TB was extrapulmonary (lymph nodes, pericardium and bones) in 5 patients. In most cases the clinical symptoms of TB were present, however, one patient was asymptomatic. Four cases were confirmed microbiologically and/or histopathologically. All patients treated with antituberculous drugs showed clinical recovery or cure, however in six patients the anti TB treatment was complicated by adverse drug reactions. One patient died and TB was diagnosed post mortem. In two patients who had had lymph nodal TB 2 and 6 years earlier, we now observed pulmonary TB. There were no cases of TB among hemodialysis unit staff.

There is a increasing incidence of TB in population of HD patients.(ABSTRACT TRUNCATED AT 250 WORDS)