Abstract: TH-PO851
Need to Think Outside the Box: Clinical Presentation and Outcome of Tuberculosis in Patients With CKD
Session Information
- Health Maintenance, Nutrition, Metabolism
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance‚ Nutrition‚ and Metabolism
- 1400 Health Maintenance‚ Nutrition‚ and Metabolism
Authors
- Patel, Mohan P., Apollo Specialty Hospitals Pvt Ltd, Nashik, MAHARASHTRA, India
- Goswami, Jitendra, Manipal Hospitals, Jaipur, Rajsthan, India
Background
Tuberculosis (TB) is still an important public health problem in Indian subcontinent and limited literature on TB among chronic kidney disease (CKD) population. Additionally, the diagnosis of TB in CKD patients is challenging because of suboptimal performance of screening and diagnostic tests. The present study aimed to investigate the clinical profile and outcome of TB in CKD patients and further assisting the complications during the treatment and recovery of the patients.
Methods
A prospective observational study was conducted in patients with CKD stage III - V, diagnosed with TB between January 2014 and December 2021. Demographic characteristics and clinical findings were recorded. Treatment with anti-TB drugs, adverse events and the outcome of patients were also noted.
Results
A total of 63 CKD patients with mean (SD) age 49.2 (18.3) years, clinically diagnosed with TB were enrolled in the study. About 72% of patients were male and 76.2% of patients (n=48) with TB had advanced CKD stage V. At the time of diagnosis of TB, 39 (81.25%) and 9 (18.75%) patients were on hemodialysis and peritoneal dialysis, respectively with mean (SD) dialysis duration was 9.2 (7.4) months. At the time of TB diagnosis, twenty-nine patients (46%) were already diagnosed to have Diabetes Mellitus. The diagnosis of TB in 58.73% patients was on the basis of microbiological/histological reports and only on clinical grounds in rest of the 41.27% patients. The majority of the patients (n=41, 65%) had extrapulmonary TB. Pleuro-pulmonary (38.09%), lymph node (26.6%), peritoneum (17.46%) and genitourinary tract (6%) were common sites for TB. About 7.9% patients had joint TB and one patient (2%) had disseminated TB. Twenty-four patients (39.68%) had adverse events related to anti-TB drugs like rifampicin induced hypertension (n=11), isoniazid induced rash (n=2) isoniazid induced cerebellitis (n=3) and hepatitis (n=9). About 69.8% of the patients in the study were survived and 30.2% died.
Conclusion
As the clinical presentations of TB in CKD patients are mostly nonspecific, leading to delay in diagnosis and treatment along with poor patient outcomes. Hence, we need to think outside the box in patients with CKD as extrapulmonary presentations are more common. Adverse events related to anti-TB drugs frequently complicate the treatment, therefore vigilance is needed.