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HEMODİYALİZ HASTALARINDA TÜBERKÜLOZ SIKLIĞI

THE INCIDENCE OF TUBERCULOSIS IN HEMODIALYSIS PATIENTS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1998

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Tuberculosis developed in 28 out of 512 hemodialysis patients during from December 1992 to December 1997. The incidence was %5.5. The mean age of patients was 45.0±l 1.6 years. Mean duration on hemodialysis before diagnosis of tuberculosis was 14.1±11.8 months and mean duration of symptoms prior to diagnosis was 2.9±1.4 months. Persisted fever, anorexia, weakness and weight loss were the mean presenting symptoms. Pulmoner tuberculosis was seen in 13 patients (%46.4), seven of whom presented with pleural effusions. There were extrapulmonary presentations in 15 (%53.6) patients. The mean erythrocyte sedimentation rate was 80±22 mm/h. Tuberculin skin test were positive in only eight (%28.5) patients. Twenty two patients were confirmed microbiologically and/or histopathologically. The remaining six patients were accepted as probable tuberculosis. The treatment protocol for all patients consisted of isomaâd 300 mg daily, rifampicin 600 mg daily and ethambutol 500 mg daily for the first 2 months and contunied with isoniazid and rifampicin for another 10 months. The two death were caused directly by tuberculosis. The two patients were died from other causes. As a conclusion: There is a high prevalance of tuberculosis in hemodialysis patients. Therefore, early diagnosis and treatment might be an important feducer to diminish the mortality
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Abstract (Original Language): 
Arahk-1992 ile Aralık-1997 tarihleri arasında hemodiyaliz merkezimizde tedavi gören toplam 512 hastanın 28'inde (%5.5) tüberküloz enfeksiyonu tespit ettik. Hastaların yaş ortalaması 45.0± 11.6 yıl, tanı öncesi ortalama hemodiyaliz süresi 14.1±11.8 ay, semptomların süresi ise ortalama 2.9±1.4 ay idi. Hastaların hepsinde subfebril ateş, halsizlik, iştahsızlık ve kilo kaybı gibi nonspesifik semptom ve bulgular mevcuttu. Tüberküloz enfeksiyonu 13 (%46.4) hastada pulmoner (7'sinde plevral tutulum), 15 (%53.6) hastada ise ekstrapulmoner yerleşim gösteriyordu. Ortalama sedimantasyon hızı 80±22 mm/h idi. Tüberkülin deri testi sekiz (%28.5) hastada pozitifti. Yirmi iki hastada tanıyı tüberküloz basilinin tespiti ve/veya histopatolojik değerlendirme ile koyduk. Diğer altı hastayı ihtimali tüberküloz vakası olarak değerlendirdik. Tedavi olarak izoniazid 300 mg/gün + rifampisin 600 mg/gün + ethambutol 500 mg/gün dozunda başladık. Ethambutolu ilk 2 ay, izoniazid ve rifampisini ise 1 yıl süre ile verdik. İki hasta tüberküloz nedeniyle, iki hasta ise diğer nedenlerle eksitus oldu. Sonuç olarak; hemodiyaliz hastalarında tüberküloz enfeksiyonuna sık rastlandığı, bu yüzden erken tanı ve tedavinin mortaliteyi azaltmada önemli olduğu kanaatine vardık.
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  • 2
74-78
  • Turkish

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