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Epidemiology and outcome of tuberculosis in immunocompromised patients
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Journal Article
Epidemiology and outcome of tuberculosis in immunocompromised patients
2017
Overview
The United States Renal Data System showed 1.2% and 1.6% incidences of
tuberculosis (TB) in patients on peritoneal dialysis and hemodialysis (HD), respectively. Kidney
transplant (KTX) patients have higher rates. We studied the epidemiology and outcome of TB in
patients with kidney dysfunction in a tertiary care hospital in the past decade. We examined data
of patients with TB with and without kidney dysfunction from 2006 to 2015 through an electronic
system. Statistical analysis was completed using Stata software, Chicago, IL, USA. We found 581
patients with active TB of whom 37 had renal dysfunction including chronic kidney disease, HD,
and KTX. No difference was found in the prevalence, age, or gender predilection. The age ranged
from 1 to 95 with a mean (standard deviation) of 38.6 (21.1) years. The incidence of TB is 3 per
100,000. The number of patients per year with active TB ranges from 52 to 128 and 3 to 4 in the
general population and kidney dysfunction group, respectively. Sixty-five percent of patients with
kidney dysfunction had pulmonary TB, 5% had pleurisy, and 30% had extrapulmonary TB.
Eighty-four percent of patients with kidney dysfunction completed the course of treatment with
16% treatment failure and 0.4% developed multidrug-resistant TB; 8% were lost to follow-up and
8% died during the treatment period. This study showed no gender predilection for TB in the
general population and immunocompromised. Duration of symptoms before diagnosis of TB was
shorter in kidney dysfunction patients in comparison to the general population. TB cultures were
the most positive tests whereas bronchoalveolar lavage and skin test were the least positive for
detecting TB in the kidney dysfunction group. Improvement in registries and screening is required
to enhance the capturing rate and detection among this group, as well as providing accurate data
Publisher
Saudi Center for Organ Transplantation,Medknow Publications and Media Pvt. Ltd,Medknow Publications & Media Pvt. Ltd,Wolters Kluwer Medknow Publications
Subject
