Buradasınız

Anasayfa » Content

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
Bookmark/Search this post with
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.
FULL TEXT (PDF): 
PDF icon pdf_tndt_208.pdf
  • 2
74-78
  • Turkish

REFERENCES

References: 

1. Cengiz K. Increased incidence of tuberculosis in patients undergoing hemodialysis. Nephron 1996; 73: 421-424.
2. Andrew OT, Schoenfeled PY, Hopewell PC, Humphreys MH. Tuberculosis in patients with end-stage renal disease. Am J Med 1980; 68: 59-65.
3. Lundin AP, Adler AJ, Berlyne GM, Friedman EA. Tuberculosis in patients undergoing maintenance hemodialysis. Am J Med 1979; 67: 597-602.
4. Homrany M. Successful therapy of tuberculosis in hemodialysis patients. Am J Nephrol 1997; 17 (1): 32-35.
77
5. Zhang X, Hou F, Wei D. Tuberculosis in chronic renal failure patients with or without renal replacement therapy. Chung Hua Nei Ko Tsa Chih 1995; 34 (10): 666-669.
6.
7.
Rutsky EA, Rostand SG. Mycobacteriosis in patients with chronic renal failure. Arch Intern Med 1980; 140: 57-61.
Sulima-Gillow A, Rutkowski B, Kustosz J, Zdrojeweski Z. Tuberculosis~an increasing risk for patients treated with long-term hemodialysis. Pol Arch Med Wewn 1994; 92 (3): 251-259.
8. Rogowski R, Imiela J, Braszkiewicz M, Kidawa E. Tuberculosis in patients chronically treated with
hemodialysis. Pol Arch Med Wewn 1993; 90 (3): 218¬225.
9. Papadimitriou M, Memmos D, Metaxas P. Tuberculosis in patients on regular haemodialysis. Nephron 1979;
24: 53-57.
10. Hussein MM, Bakir N, Roujoule H. Tuberculosis in patients undergoing maintenance dialysis. Nephrol Dial
Transplant 1990; 5: 584-587
11. Smirnoff M, Part C, Seckler B, Adler J J. Tubercilin and
anergy skin testing of patients receiving long-term
hemodialysis. Chest 1998; 113 (1): 25-27.
12. Fang JT, Huang CC. Unusual presentations of extrapulmonary tuberculosis in three hemodialysis patients. Ren Fail 1997; 19 (3): 485-490.
13. Murthy BV, Pereira BJ. A 1990s perspective of
hepatitis C, human immundeficiency virus, and tuberculosis infections in dialysis patients. Semin Nephrol 1997: 17 (4): 346-363.
14. Shahaway MA, Gadallah MF, Campese VM.
Tuberculosis of the spine (Pott's disease) in patients with end-stage renal disease. Am J Nephrol 1994; 14
(1): 55-59.
15. Hussein MM, Mooij JM, Roujouleh H, el-Sayed H.
Observations in a Saudi-Arabian dialysis population over a 13-year period. Nephrol Dial Transplant 1994;
9(8): 1072-1076.
78

Thank you for copying data from http://www.arastirmax.com