THE INCIDENCE OF TUBERCULOSIS IN HEMODIALYSIS PATIENTS

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.