Risk of tuberculosis in dialysis patients: a population-based study

SETTING: Provincial tuberculosis (TB) and dialysis registries. OBJECTIVE: TO document the risk of TB among patients on dialysis and to des cribe the clinical characteristics of these cases. METHODS: All cases of TB occurring among dialysis patients in British Colum bia between January 1990 and December 1994 were reviewed, as were the age-s pecific rates for TB among the general population during the same period. RESULTS: During that period, a total of seven cases of TB occurred among 56 0 patients on hemo-dialysis and two cases among 326 patients on peritoneal dialysis. On an annual basis the rate of TB in the dialysis population was 253 per 100 000, compared to an age-matched rate of 10.1 per 100 000 in the general population, giving a relative risk of 25.3 (95% confidence interva l 22.86-31.49, P = 0.0000001). CONCLUSIONS: The risk of TB in dialysis patients is significantly higher th an previously reported from non population-based studies, indicating that d ialysis patients should be considered a possible target population for syst ematic evaluation for the presence of TB infection and consideration for ch emoprophylaxis.