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Risk of tuberculosis in dialysis patients: a population-based study
1Division of TB Control, BC Center for Disease Control and Departement of Medicine, University of British Columbia, Vancouver, Canada.
Setting:
Provincial tuberculosis (TB) and dialysis registries.
Objective:
To document the risk of TB among patients on dialysis and to describe the clinical characteristics of these cases.
Methods:
All cases of TB occurring among dialysis patients in British Columbia between January 1990 and December 1994 were reviewed, as were the age-specific rates for TB among the general population during the same period.
Results:
During that period, a total of seven cases of TB occurred among 560 patients on hemo-dialysis and two cases among 326 patients on peritoneal dialysis. On an annual basis the rate of TB in the dialysis population was 253 per 100,000, compared to an age-matched rate of 10.1 per 100,000 in the general population, giving a relative risk of 25.3 (95% confidence interval 22.86-31.49, P = 0.0000001).
Conclusions:
The risk of TB in dialysis patients is significantly higher than previously reported from non population-based studies, indicating that dialysis patients should be considered a possible target population for systematic evaluation for the presence of TB infection and consideration for chemoprophylaxis.