Increased incidence of tuberculosis in chronic hemodialysis patients

We encountered 9 cases of tuberculosis out of our 157 chronic HD patients in 36 months. Four pulmonary, 4 lymph nodal and one isolated dermal involvement were detected. Therapy was commenced without waiting for absolute cultural or pathologic diagnosis because of the high index of clinical suspicion. All cases except one recovered completely. Among associated conditions, peptic ulcer disease, anti-HCV positivity, and diabetes mellitus were noted, though the last two did not reach statistical significance. Prompt institution of the specific therapy and close supervision of the cases during treatment enabled us to obtain a cure in all cases except one and to discern adverse drug effects immediately and to make appropriate changes in the therapy. Thus, no morbidity due to the disease itself or drugs was observed. Copyright (C) 2001 S. Karger AG, Basel.