Increased incidence of tuberculosis in patients on renal replacement therapy in the last decade

Ležaić, Višnja; Popovic, Zoran; Radivojević, Dušan; Oštrić, Vladimir; Blagojevic, R.; Lj, Djukanović

doi:10.1093/ndt/15.2.283-a

Cited by 5 publications

(2 citation statements)

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“…The first report of an increased prevalence of TB in dialysis patients appeared in 1974 (2). Later, many studies, several of which are summarized in Table 1, have confirmed a 6.9‐ to 52.5‐fold increased risk of TB in patients with chronic renal failure and on dialysis as compared to the general population (3–30); an even higher risk (100‐fold) was reported from a center in London with a high immigrant population (31). Despite the well‐known association between diabetes mellitus and TB, especially pulmonary (32), only two (22,31) of the quoted studies (2–31) found a higher prevalence of TB in dialysis patients with diabetes mellitus, as compared with other renal diseases.…”

Section: Epidemiologymentioning

confidence: 98%

“…The nonspecific presenting symptoms together with the frequent extrapulmonary localization constitute risk factors for a delay in the diagnosis of TB, which unfortunately has been observed in several studies. Within the extrapulmonary group, tuberculous lymphadenitis and peritonitis are the most reported localizations; less frequently cases of military, spine (Pott's syndrome), cerebral, and genitourinary TB have been reported (2–31).…”

Section: Featuresmentioning

confidence: 99%

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Tuberculosis and Chronic Renal Disease

Hussein

Mooij

Roujouleh

2003

Seminars in Dialysis

180

164

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There is an increased risk (6.9- to 52.5-fold) of tuberculosis (TB) in patients with chronic renal failure and on dialysis as compared to the general population. The symptomatology in renal patients is often insidious and nonspecific, mimicking uremic symptoms, whereas the localization is often extrapulmonary (most frequently tuberculous lymphadenitis and peritonitis). Tuberculous peritonitis makes up a large part (37%) of the total number of TB cases in continuous ambulatory peritoneal dialysis (CAPD) patients. The prognosis is very much dependent on early diagnosis and treatment. Renal physicians should be aware of the unusual presentation and localization, and include TB in the differential diagnosis of any patient having nonspecific symptoms like anorexia, fever, and weight loss. All efforts should then be made (including invasive investigations) to reach an early diagnosis, a major determinant of the outcome. However, if this is not possible or the result is negative and the diagnosis remains strongly suspected, an empirical trial with anti-TB medication is justified, especially in endemic areas. In view of the increased prevalence of the disease in the dialysis population, TB prophylaxis is recommended in those patients with a positive tuberculin (Mantoux) skin test and radiographs suggestive of old TB.

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