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[Tuberculosis in patients undergoing hemodialysis]

Toshinobu Yokoyama1, Toru Rikimaru, Rumi Gohara

  • 1First Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka 830-0011, Japan. yokoyama-t@nyc.odn.ne.jp

Kekkaku : [Tuberculosis]
|August 23, 2003
PubMed

Insights

Patients on hemodialysis with active tuberculosis show depressed cellular immunity. Prompt recognition of peripheral neuropathy and pyridoxine use are crucial for favorable outcomes in these tuberculosis patients.

Area of Science:

  • Nephrology
  • Immunology
  • Infectious Diseases

Context:

  • Tuberculosis (TB) incidence and mortality are elevated in hemodialysis patients.
  • Hemodialysis patients at Kurume University Hospital were assessed for active TB.
  • Immunologic and clinical features of TB in hemodialysis patients were investigated.

Purpose:

  • To investigate the immunologic and clinical characteristics of active tuberculosis in patients undergoing hemodialysis.
  • To evaluate the outcomes of antitubercular chemotherapy in this patient population.

Summary:

  • Cellular immunity is impaired in hemodialysis patients with TB, indicated by reduced lymphocytes and anergy to purified protein derivative (PPD) skin tests.
  • Hemodialysis may reduce interferon-gamma (IFN-gamma) levels in some patients.
  • Despite higher general risks, favorable clinical outcomes were observed in this study's cohort.
  • Peripheral neuropathy must be promptly identified and managed with pyridoxine to prevent complications.

Impact:

  • Highlights the importance of monitoring immune status in hemodialysis patients with TB.
  • Emphasizes the need for vigilant management of potential side effects like peripheral neuropathy.
  • Suggests that with appropriate care, active TB in hemodialysis patients can have a positive prognosis.

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