OBJECTIVE: To elucidate the clinical manifestations and risk factors of the mortality rate in uraemic patients with tuberculosis (TB) infection. DESIGN: We retrospectively analysed 62 patients with uraemia and active tuberculosis who were admitted to our hospital from 1990 through 2000. The patients were followed up for 2 years after discharge or until death. RESULTS: There were 43 men and 19 women, with a mean age of 63 +/- 13 years. Extra-pulmonary TB was noted in 51.6%. The peritoneum and pleura were the two most common organs involved. Fever of unknown origin was the most common manifestation (77.4%). The corrected serum Ca2+ level of the patients was >10.5 mg/dl in 46.8%. C-reactive protein >6 mg/dl and leukocytosis (white blood cell count >10,000/mm3) at presentation were noted in more than half of the patients. A reversed serum albumin/globulin ratio and leukocytosis were found to be associated with mortality rate. CONCLUSION: More than half of the TB infections in patients with end-stage renal disease presented with extra-pulmonary involvement. Fever of unknown origin, reversed serum albumin/globulin ratio, and unexplained hypercalcaemia in maintenance dialysis patients suggested the possibility of tuberculosis.
OBJECTIVE: To elucidate the clinical manifestations and risk factors of the mortality rate in uraemic patients with tuberculosis (TB) infection. DESIGN: We retrospectively analysed 62 patients with uraemia and active tuberculosis who were admitted to our hospital from 1990 through 2000. The patients were followed up for 2 years after discharge or until death. RESULTS: There were 43 men and 19 women, with a mean age of 63 +/- 13 years. Extra-pulmonary TB was noted in 51.6%. The peritoneum and pleura were the two most common organs involved. Fever of unknown origin was the most common manifestation (77.4%). The corrected serum Ca2+ level of the patients was >10.5 mg/dl in 46.8%. C-reactive protein >6 mg/dl and leukocytosis (white blood cell count >10,000/mm3) at presentation were noted in more than half of the patients. A reversed serum albumin/globulin ratio and leukocytosis were found to be associated with mortality rate. CONCLUSION: More than half of the TB infections in patients with end-stage renal disease presented with extra-pulmonary involvement. Fever of unknown origin, reversed serum albumin/globulin ratio, and unexplained hypercalcaemia in maintenance dialysis patients suggested the possibility of tuberculosis.
Authors: Abdurrahman M Hamadah; Lynn M Beaulieu; John W Wilson; Timothy R Aksamit; James R Gregoire; Amy W Williams; John J Dillon; Robert C Albright; Macaulay Onuigbo; Venkateshwaran K Iyer; LaTonya J Hickson Journal: Nephron Date: 2016-02-10 Impact factor: 2.847
Authors: S S J Lee; K J Chou; I J Su; Y S Chen; H C Fang; T S Huang; H C Tsai; S R Wann; H H Lin; Y C Liu Journal: Infection Date: 2008-12-10 Impact factor: 3.553