Journal Article

The diagnosis of tuberculosis in dialysis patients

Beji, Sumayyah, Barrah, Sana, Zuaghi, Muhammad Karim, Beji, Majid, Tiouiri, Hanini, Rais, Lamya, Jabali, Halah, Smaoui, Wided, Bin Fatimah, Layla, Bin Hamidah, Fathi, Khouja, Nihal, Khidr, Raniya, Abd al-Malik, Rim, Mahiri, Salma Nadiyah

2017

Overview

The incidence of tuberculosis (TB) is high in patients undergoing chronic dialysis than it is in the general population. The diagnosis of TB is often difficult and extrapulmonary involvement is predominant. This study investigates the spectrum of clinical presentations and outcome in dialysis patients during a nine-year period. TB was diagnosed in 41 patients. Anti-TB drugs, adverse effects of therapy, and outcome were noted. Thirty-eight patients (92.6%) were on hemodialysis and three were on peritoneal dialysis (7.3%). The mean age at diagnosis was 50.8 years and the male/female ratio was 1.16. Four patients had a history of pulmonary TB. Extrapulmonary involvement was observed in 32 (78 %) patients. The bacteriological confirmation was made in 41.46% and histological confirmation was made in 26.83%, and in the rest, the diagnosis was retained on the criterion presumption. Nineteen patients (46.34%) developed adverse effects of antitubercular drugs. Eight patients (19.51%) died during the study from TB or adverse effects of treatment. Low urea reduction ratio and female sex were associated with poor prognosis in our study. The clinical manifestations of TB in patients on dialysis are quite nonspecific, making timely diagnosis difficult, and delaying the initiation of curative treatment, which is a major determinant of the outcome

• Publisher: Saudi Center for Organ Transplantation,Medknow Publications and Media Pvt. Ltd,Medknow Publications & Media Pvt. Ltd,Wolters Kluwer Medknow Publications
• Subject: Adult / Aged / Aged, 80 and over / Antitubercular Agents - therapeutic use / Bacteriological Techniques / Care and treatment / Clinical Decision-Making / Diagnosis / Diagnostic tests / Disease control / Drug dosages / Early Diagnosis / Female / Health aspects / Hemodialysis patients / Hospitals / Humans / Infections / Infectious diseases / Kidney diseases / Kidney Failure, Chronic - diagnosis / Kidney Failure, Chronic - epidemiology / Kidney Failure, Chronic - therapy / Laboratories / Male / Medical diagnosis / Middle Aged / Nephrology / Patients / Peritoneal dialysis / Peritoneal Dialysis - adverse effects / Population / Predictive Value of Tests / Prevalence / Renal Dialysis - adverse effects / Renal Dialysis - methods / Retrospective Studies / Risk Factors / Skin / Society / Time Factors / Treatment Outcome / Tuberculosis / Tuberculosis - diagnosis / Tuberculosis - drug therapy / Tuberculosis - epidemiology / Tuberculosis - microbiology / Tunisia - epidemiology / Young Adult / التشخيص / المرضى / غسيل الكلى / مرض السل