The Prevalence and the Characteristics of Tuberculosis Patients Undergoing Chronic Dialysis Treatment: Experience of a Dialysis Center in Southeast Turkey

Kayabaşı, Hasan; Şit, Dede; Kadiroglu, Ali Kemal; Kara, İsmail Hamdi; Yılmaz, Mehmet Emin

doi:10.1080/08860220802064721

Cited by 14 publications

(20 citation statements)

References 21 publications

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“…The clinical features of disseminated TB in hemodialysis patients are fever of unknown origin, anorexia, night sweats, lymphadenopathy, pleural effusion, pericardial effusion, and weight loss [16]. These symptoms are similar to those observed in patients with uremia.…”

Section: Discussionsupporting

confidence: 58%

“…In cases of suspected pulmonary TB, chest X-rays and sputum analysis are important; however, in patients with disseminated tuberculosis who do not have active pulmonary disease, identifying the mycobacterial organism may be extremely difficult by sputum analyses [16]. Alternative methods include obtaining pleural, ascitic, cerebrospinal, or peritoneal dialysis fluid analysis or biopsy of lymph nodes, pleura, bone marrow, or other tissues for smears and culture.…”

Section: Discussionmentioning

confidence: 99%

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A case of disseminated tuberculosis after the initiation of hemodialysis

Hasegawa

Wakai

2013

CEN Case Rep

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A 67-year-old man with diabetes mellitus, chronic kidney disease, chronic heart failure, and amputation of the left lower limb was admitted to our hospital with decreasing renal function. On admission, he was started on hemodialysis. He simultaneously developed a urinary tract infection, infected necrotic wound of the right lower limb, and pneumonia, and was treated with broad-spectrum antibiotics. Although his general condition improved, fever and anorexia persisted and jaundice worsened. He died 138 days after admission. Autopsy revealed granulomas in the lungs, liver, and spleen. Cultures revealed Mycobacterium tuberculosis, leading to the diagnosis of disseminated tuberculosis.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

A case of disseminated tuberculosis after the initiation of hemodialysis

Hasegawa

Wakai

2013

CEN Case Rep

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“…There have been different reports about the incidence and prevalence of TB in patients on dialysis treatment [5,6], but literature comparing the modalities of dialysis regarding the prevalence and incidence of TB is scarce.…”

Section: Discussionmentioning

confidence: 99%

“…Data on the incidence and prevalence of TB in dialysis patients varies and depends on the study region [5,6]. Although noted mostly as case reports, PD patients have increased incidence of peritoneal involvement compared to the HD population, suggesting a direct relationship with dialysis [5].…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis in dialysis patients: a nine-year retrospective analysis

Ünsal

Ahbap

Baştürk

et al. 2013

J Infect Dev Ctries

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Introduction: Diagnosis of tuberculosis (TB) among dialysis patients may be difficult because of increased frequency of extra-pulmonary presentations, atypical clinical manifestations, and non-specific symptoms. This study aimed to investigate the spectrum of clinical presentations and outcome in dialysis patients during a nine-year period. Methodology: A total of 651 patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) for at least three months in our unit between 2001 and 2010 were studied. Dialysis and follow-up were performed in our tertiary care center located in the eastern region of Turkey. Diagnosis of TB was established by combining clinical, radiological, biochemical, microbiological, and histological findings. Choice of anti-TB drug used, the results of therapy, and patient outcome were noted. Results: Out of 651 dialysis patients studied, 322 (49.4%) were on PD and the remainder on HD (50.6%). Twenty-six (4%) of the 651 dialysis patients were diagnosed with TB (15 PD, 11 HD), 5 of whom were diagnosed by microbiological assessment, 9 by pathological assessment, and 12 by clinical and radiological findings. Mean age at diagnosis was 41.5 ± 16.5 years and the female/male ratio was 1.18. Three patients had a history of pulmonary TB. Extra-pulmonary involvement was observed in 17 (65.4%) patients. All patients were treated with rifampicin isoniazid, ethambutol, pyrazinamide and pyridoxine. Four patients died during the study. Conclusion: TB occurred in dialysis patients and extra-pulmonary TB was more commonly identified than pulmonary TB. Tuberculous lymphadenitis was the most frequent form of extra-pulmonary TB in our cohort.

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“…Extrapulmonary TB has been reported in as many as 60% to 80% of cases, either alone or associated with pulmonary TB. The most common forms of presentation are lymphadenitis, gastrointestinal, bone, genitourinary, peritonitis, pleural effusion, pericardial effusion, miliary TB, and pyrexia of unknown origin (7)(8)(9)(10). On the other hand, uremia is commonly associated with fatigue, malnutrition, and other nonspecific complaints, possibly concealing the course of an underlying TB disease (7,11,12).…”

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confidence: 99%

Diagnosis of Tuberculosis in Dialysis Patients

Segall

Covic²

2010

Clinical Journal of the American Society of Nephrology

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Patients with ESRD undergoing chronic dialysis are much more prone to develop tuberculosis (TB) than the general population. In these patients, the diagnosis of TB disease is often difficult because of prevailing extrapulmonary involvement and nonspecific symptoms. The prevalence of latent TB infection (LTBI) in ESRD patients is elevated, and those who become infected are at high risk of developing active disease. Therefore, screening for LTBI in this population is recommended, aiming to prevent progression to active TB and secondary contamination of others. The tuberculin skin test (TST), the classic diagnostic tool for LTBI, has several major drawbacks, including poor sensitivity (because of a high prevalence of anergy in dialysis patients) and specificity [with false-positive tests in those vaccinated with bacille Calmette-Guérin (BCG)]. In the past 10 years or so, new immunological tests using IFN-␥ release assays (IGRAs) have become available and have shown superior sensitivity and specificity for the diagnosis of TB compared with the TST in several studies, some very recent ones including ESRD patients. Therefore, current strategy in dialysis patients should use these tests instead of TST for LTBI screening and as an aid for the diagnosis of active TB.

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The Prevalence and the Characteristics of Tuberculosis Patients Undergoing Chronic Dialysis Treatment: Experience of a Dialysis Center in Southeast Turkey

Cited by 14 publications

References 21 publications

A case of disseminated tuberculosis after the initiation of hemodialysis

A case of disseminated tuberculosis after the initiation of hemodialysis

Tuberculosis in dialysis patients: a nine-year retrospective analysis

Diagnosis of Tuberculosis in Dialysis Patients

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