Introduction:
Patients with end stage kidney disease (ESKD) are at a higher risk of developing tuberculosis (TB) due to the immunosuppressed state along with concomitant comorbidities and socioeconomic and demographic factors. Despite high burden of Tuberculosis, There is scarce data on spectrum and outcome of Tuberculosis in chronic hemodialysis patients from North India.
Methods:
This was a single-center prospective observational study in the HD unit of ILBS Vasant Kunj, New Delhi. The study was conducted between 2018 to 2024.
Results:
Over the period of 6 years, 780 patients underwent chronic hemodilaysis in our center. the incidence of TB was 17.30%( 135/780). The median time to presentation was 7 months from HD initiation. The median age was 45 (IQR) years with 56 percent females. The comorbidities included hypertension, diabetes, heart disease with 96%, 84% and 59% respectively. The spectrum of TB included pleural effusion(54%), Pulmonary Koch(24%), TB abdomen(11%), lymph node TB (8%), spine TB (2%), and others (1%). The outcome was classified as treated, relapse, death. Additionally, 12 of 109 underwent uneventful kidney transplant while on AKT.
Conclusions:
Prevalence of TB is very high in dialysis patients, particularly during the first year of dialysis. Shortâterm mortality is high, but the diagnostic sensitivity of many types of samples is low, so that diagnosis is difficult, with treatment often initiated without confirmation. These data highlight the importance of judgment and clinical experience with this complex patient group.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.