Tuberculosis in peritoneal dialysis patients in an endemic region.

Abstract

Tuberculosis has been paid more attention in recent years because of the increase in the number of patients with immune suppression-such as those with renal failure. In the present study, we analyzed patients on peritoneal dialysis (PD) in our city to determine the prevalence and clinical characteristics of tuberculosis in those patients. Patients who had been on a PD program for more than 3 months were reviewed. Demographic characteristics, primary renal disease, comorbidities, and duration of PD were recorded. With regard to tuberculosis, the timing of the diagnosis, any previous history of antituberculosis treatment, family history, site of presentation, drugs used, drug side effects, and disease outcome were recorded. Among 322 patients from 5 PD units who were reviewed, 4 (1.240%) were found to have tuberculosis. Pulmonary involvement was noted in 2 (50%). The diagnosis was made through microbiology in 1 patient, through pathology in 1, and through clinical and radiologic assessment in the remaining 2. Mild transaminitis was recorded in 2 patients as a side effect of treatment. Of the 4 patients, 2 were cured, 1 died, and 1 was taking ongoing treatment. The prevalence of tuberculosis was significantly higher in the study population than in the general population. In a dialysis population, a diagnosis of tuberculosis is often difficult, and extrapulmonary involvement is more common, as observed in our study. The diagnosis of tuberculosis may be made through non-microbiologic approaches, and temporary transaminase elevations may be seen during therapy.