INCREASED INCIDENCE OF TUBERCULOSIS IN PATIENTS UNDERGOING HEMODIALYSIS

Tuberculosis was diagnosed in 26 patients (6 females and 20 males) und ergoing maintenance hemodialysis, with an incidence of 23.6%. Infectio n was characterized clinically by a very insidious onset, the main sym ptoms being anorexia, loss of weight and low-grade fever, a very high sedimentation rate and lymphocytes predominant in the peripheral circu lation, pleural and peritoneal fluids. Pulmonary tuberculosis was seen in 18 patients (70%), 10 of whom presented with pleural effusions. Th ere were extrapulmonary presentations in 8 of the 26 patients (30%). M ost of the patients developed the disease about 1 year from the start of their dialysis treatment. With early therapy all patients survived their tuberculosis disease and no recurrence was seen in up to 5 years of follow-up. Despite earlier reports of high mortality, we suggest t hat awareness of the increased incidence of tuberculosis in dialysis p atients, together with its unusual presentation and consequent early d iagnosis, results in a very good prognosis.