Tuberculosis in hemodialysis

Amrani, Mohamed; Mohamed, Abdelrahman; Bahadi, Abdelali; Kabbaj, Driss El; Benyahia, M.

doi:10.1684/mst.2016.0569

Cited by 9 publications

(11 citation statements)

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“…In our study, with 3 patients, or 8.57% of cases, GeneXpert was positive (Table 4). Our results are lower than those of El Amrani M. et al [12] in Morocco in 2016, which found a frequency of 23% of tuberculosis cases diagnosed with Ge-neXpert in hemodialysis patients. This low frequency in our patients could be explained by the low use of GeneXpert due to the cost.…”

Section: Discussioncontrasting

confidence: 88%

Pleurisy in Hemodialysis Patients: Epidemiological and Etiological Aspects at Donka National Hemodialysis Center

Traoré¹,

Diakité²,

Baldé³

et al. 2021

OJNeph

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Introduction: Pleural effusion being a frequent complication in hemodialysis patients, its etiologies are diverse and the diagnosis is easy, based on clinical and radiological proofs. The main objective of this study was to describe the epidemiological and etiological profiles of pleurisy in hemodialysis patients at the National Hemodialysis Center of Donka National Hospital. Patients and methods: it was a retrospective, descriptive and analytical study that extended over a period of three years from January 1, 2017 to December 31, 2019. It concerned, among hemodialysis patients in the center during the study period, all those who had a confirmed pleurisy on chest x-ray. The variables were epidemiological (based on frequency, sex and age), clinical (based on history of the disease, physical examination looking for a reduction or elimination of vesicular murmur) and paraclinical (mainly radiological). Results: Among 286 patients undergoing hemodialysis in our center, pleural effusion was diagnosed in 35 or 12.24%. The average age of our patients was 52.22 years with ranges of 18 and 78 years. The sex ratio M/F was 2.5. Bilateral pleurisy was found in 51.43% of patients; unilateral right in 40% of cases and unilateral left in 8.57%. We observed 68.57% citrus yellow fluid and 31.43% sero haematic fluid. The bacteriology of the pleural fluid was positive in 62.86% against 37.14% negative. Tumor, tuberculosis and non-specific bacterial etiologies have been encountered. Conclusion: Pleurisy is therefore a frequent complication in hemodialysis patients at Donka National Hemodialysis Center. Etiological research is a major step for better management of these patients. Improving the technical platform of the laboratories should be an important contribution to this stage.

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Section: Discussioncontrasting

confidence: 88%

Pleurisy in Hemodialysis Patients: Epidemiological and Etiological Aspects at Donka National Hemodialysis Center

Traoré¹,

Diakité²,

Baldé³

et al. 2021

OJNeph

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“…We also identified chronic kidney disease as a risk factor for AIDS during the follow-up (Table 3 ). These results are likely attributable to the defective immune system through both immune activation and immune suppression [ 54 ], which might result in the reactivation of Mycobacterium tuberculosis or other AIDS-defining opportunistic infections [ 55 – 57 ]. In summary, given the diversity of care needs of the various HIV-at-risk populations, identification of the modifiable factors associated with AIDS incidence after linking to the HIV care is vital to better customize the HIV-care strategies for HIV-at-risk populations in Taiwan.…”

Section: Discussionmentioning

confidence: 99%

AIDS incidence trends at presentation and during follow-up among HIV-at-risk populations: a 15-year nationwide cohort study in Taiwan

Lee

Jen²,

Lan

et al. 2018

BMC Public Health

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BackgroundAlthough Taiwan has implemented several important interventions for various HIV-at-risk populations to combat the HIV epidemic, little is known regarding AIDS incidence at presentation and during follow-up among the various HIV-at-risk populations in Taiwan. A better understanding of AIDS incidence trends would help improve patient care and optimize public health strategies aimed at further decreasing HIV-related morbidity and mortality.MethodsData from Taiwan Centers for Disease Control-operated Notifiable Diseases Surveillance System and Taiwan National Health Insurance Research Database (1998–2012) was divided into five cohort periods (consecutive 3-year groups). Logistic regression was employed to identify factors associated with AIDS incidence at presentation. Time-dependent Cox regression was used to identify factors associated with AIDS incidence during the follow-up period.ResultsOf 22,665 patients [mean age: 32 years; male (93.03%)], 6210 (27.4%) had AIDS incidence over 2 (1.16) [median (interquartile range)] years of follow-up. AIDS developed in ≤3 months of HIV diagnosis in 73.6% AIDS patients. AIDS incidence trends at presentation and during follow-up differed according to HIV transmission routes over the five periods: AIDS at presentation increased in the sexual contact groups (P < 0.001 for homosexuals/heterosexuals; 0.648 for bisexuals) but decreased to a nadir in period 3 and then increased slightly in period 5 (P < 0.001) in people who injected drugs (PWIDs). AIDS incidence during the follow-up period increased from period 1 to a peak in period 3 or 4, before declining slightly in period 5, in the sexual contact groups (P < 0.001 for homosexuals/heterosexuals; 0.549 for bisexuals). However, it increased throughout the five periods in PWIDs (P < 0.001). Older age, sexual contact group versus PWIDs, high versus low income level, cohort periods, and HIV diagnosis regions helped predict AIDS at presentation and during follow-up.ConclusionsDisparities in AIDS incidence trends in various HIV-at-risk populations reflect different sociodemographic variables of HIV exposure and the adopted HIV prevention strategies. This study suggests the urgent need for tailored strategies aimed at specific populations at presentation and during follow-up.

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“…In a literature review, the authors note a relative risk of 6.9 to 52.5% [ 10 ]. However, this risk remains 7 to 250 times higher than in the general population [ 11 , 12 ]. In our study, we also note an incidence of tuberculosis in dialysis patients eight times higher than in the general population, i.e., 6.8 per thousand chronic dialysis patients per year compared to 79 cases per 100,000 inhabitants per year in the central region of Morocco in 2021 [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of tuberculosis remains a huge challenge due to the atypical clinical presentation, the increased frequency of extra-pulmonary localizations, and the negativity of bacteriological samples [ 2 , 11 , 12 , 15 - 17 ]. In our series, the most frequent manifestations included an alteration of the general state (83%) and a prolonged fever (66%), which was in line with the data in the literature [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis in Dialysis Patients in the Central Region of Morocco: What Is the Health-Care Delay?

Bardai¹,

Kabbali²,

Baba³

et al. 2022

Cureus

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Introduction: Due to the predominantly cellular immunosuppression, infections are frequent in chronic dialysis patients, in particular tuberculosis (TB). The main objective of our study is to evaluate tuberculosis healthcare delay in dialysis patients and to raise the diagnostic challenge in these patients. Material and methods: The study is retrospective and multicenter including tuberculosis cases of chronic dialysis patients either in hemodialysis (HD) or peritoneal dialysis (PD) in the central region of Morocco during a 10-year period between 2012 and 2021. Results: We included 94 patients, five of whom were in PD, with a mean age of 50.79 ± 16.72 years, and a sex ratio of 0.67. The time between the initiation of dialysis and the onset of the clinical and biological presentation was 50.3 ± 67.12 months. The most frequent initial manifestations were an alteration of the general state (85.1%), a biological inflammatory syndrome (83%) or a prolonged fever (70.1%). Among our 94 patients, the diagnosis was confirmed with bacteriological evidence only in 18 cases (19.1%), by identification of Koch's Bacillus (BK) in 13 cases, by molecular biology test (GeneXpert; Cepheid, Inc., Sunnyvale, CA, USA) in five cases. The diagnosis of tuberculosis was presumptive in most cases (79 cases), i.e. 80.9%. Twenty-one patients underwent the interferon gamma release essay test (QuantiFERON; Qiagen, Hilden, Germany) which was positive in 14 patients. Thirty-four (36.1%) cases had a histological diagnosis. The remaining patients were offered a trial treatment. Tuberculosis localization was mostly extra-pulmonary (75.5%): lymph node (23.4%), pleural (13.8%), peritoneal (13.8%), whereas it was pulmonary in 23 cases (24.5%). Most of our patients had a clear delay in management from symptom onset to initiation of anti-TB treatment 78.9% (time >21days) vs 21.1% (time ≤21days). The median time to management delay was 46.5 interquartile range (IQR) (28.5-90), the mean delay was 78.4 ± 87.9 (6-360). All patients were treated according to the RHZE/RH protocol (R: rifampicin, H: isoniazid Z: pyrazinamide and E: ethambutol), with a duration between six and 18 months. Side effects associated with anti-tuberculosis treatment were observed in half of the patients (51.1%). The evolution was favorable with remission and improvement of the general condition in 90% of cases. Two cases of resistance were noted in our series. The overall mortality was 7.7%. Conclusion: We have confirmed a delay in the diagnosis and treatment of tuberculosis in chronic dialysis patients. This can be explained by the often atypical or incomplete clinical and paraclinical presentation and the extra-pulmonary localizations, making diagnosis difficult in this population whose prognosis remains poor. It is therefore necessary to establish a diagnostic approach that is adapted to the specificities of these high-risk patients within the framework of a national tuberculosis control program.

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Tuberculosis in hemodialysis

Cited by 9 publications

References 0 publications

Pleurisy in Hemodialysis Patients: Epidemiological and Etiological Aspects at Donka National Hemodialysis Center

Pleurisy in Hemodialysis Patients: Epidemiological and Etiological Aspects at Donka National Hemodialysis Center

AIDS incidence trends at presentation and during follow-up among HIV-at-risk populations: a 15-year nationwide cohort study in Taiwan

Tuberculosis in Dialysis Patients in the Central Region of Morocco: What Is the Health-Care Delay?

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