TUBERCULOSIS IN DIALYSIS PATIENTS

In a retrospective study over a 15-year period, we identified seven ca ses of tuberculosis (TB) among 158 dialysis patients. The incidence of tuberculosis among patients with end stage renal disease (ESRD) was m uch greater than normal population. The average duration ei hemodialys is al time of diagnosis was 8.5 months and one patient was diagnosed b efore starting dialysis therapy. Clinical features were non-specific i n most instances, tuberculin test were unhelpful for diagnosis in almo st all cases, and examination of sputum and other fluids for acid-fast bacilli was usually unrewarding. Extrapulmonary disease ocurred in 72 ,52%. Diagnosis was confirmed in all patients by positive culture. The rapy was effective in all patients. We argue in favour of making a cli nical trial with antituberculous drugs in patients with a high index o f suspicion, and we suggest the administration of chemoprophylaxis for tuberculosis in those ESRD patients with high risk during the first y ear on dialysis.