Successful therapy of tuberculosis in hemodialysis patients

Tuberculosis associated with dialysis was studied at the Artificial Kidney Unit (AKU) in Abha, Saudi Arabia. There were 13 tuberculosis patients out of 270 patients on maintenance hemodialysis from August 1986 to July 1993, a prevalence of 4.8%. Ten (77%) were female and 3 (23%) were male, mean age of 51.23 +/- 11.62 years. The main site of tuberculosis was pulmonary in 8 (62%) patients, in contrast to other studies. Mean duration on hemodialysis before diagnosis of tuberculosis was 19.23 +/- 14.43 months and mean duration of symptoms prior to diagnosis was 4.54 +/- 3.38 weeks. Anorexia, fever and weight loss were the main presenting symptoms. The tuberculin test was negative in all patients. Choice of treatment using three or four drug regimens for 12 and 6 months, respectively, led to full recovery in all patients with no recurrence. Despite earlier reports of high mortality in such a group of patients, it is suggested that awareness of the increased prevalence of tuberculosis in dialysis patients, together with recognition of its unusual presentation, culminated in early diagnosis and treatment with successful outcomes.