A CLINICAL PROFILE OF TUBERCULOSIS IN CKD PATIENTS AND THE RESPONSE TO MODIFIED ATT
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 38
Abstract
BACKGROUND Tuberculosis (TB) is one of the major causes of mortality across the world. Patients with CKD are at high risk of developing TB due to the immunosuppressive effects of uraemia. There is limited information on the magnitude of problem of TB in patients with CKD. Aim: The aim of the study was to find out the clinical profile and response to treatment of TB in CKD patients. MATERIALS AND METHODS This is a descriptive study carried out on 55 cases of CKD. The patients were grouped into various stages of CKD based on GFR calculated using the MDRD equation. The microbiological, histopathological, radiological and newer diagnostic investigations were noted for each patient with TB. Also, the duration of ATT taken, and any incidence of adverse drug reaction were observed. RESULTS In our study subjects, the mean age was 40 yrs., of which 75% constituted males and 25% females. Majority the patients were of post-renal transplant and stage V (31% each). Pulmonary TB contributed 64% cases (Majority in Stage IV and V) and extrapulmonary TB 36% (especially in post-renal transplant subjects). The mean duration of ATT was 7 months with 28 cases of treatment completed, 23 cured, 1 failed and 3 defaulters. Only 1.8% patients developed adverse drug event in the form of peripheral neuropathy, due to INH, despite taking pyridoxine supplements. CONCLUSION Incidence of Pulmonary TB is more common in post-transplant subjects, whereas extrapulmonary TB (Lymph node) is more common in CKD subjects. A high index of suspicion should be maintained by ensuring early screening for risk factors like smoking, alcoholism and diabetes mellitus as they predispose CKD patients to tuberculosis. GeneXpert assay is a novel and reliable diagnostic modality for TB, especially in CKD subjects for whom many of the conventional methods may be negative.
Authors and Affiliations
Anusuya Meganathan, S. Anu
Keywords
Related Articles
- EP ID EP548043
- DOI 10.14260/jemds/2018/927
- Views 90
- Downloads 0
A STUDY OF TRAUMATIC BRAIN INJURIES AT A TERTIARY CARE HOSPITAL IN KARNATAKA, SOUTH INDIA
[b]OBJECTIVE: [/b]To analyze the causes, various risk factors and treatment outcomes of traumatic brain injuries in a tertiary care hospital. [b]METHOD:[/b] A Retro-prospective study from January 2012 till August 2...
A STUDY OF PREVALENCE OF ESSENTIAL HYPERTENSION IN SCHOOL GOING EARLY AND MID-ADOLESCENT CHILDREN OF RURAL AREA IN BHOPAL
[b]OBJECTIVE: [/b]The general objective of the study is to find out prevalence of essential hypertension among early and mid-adolescent of school going children of rural area Bhopal. [b]METHODS[/b]: Blood press...
CLINICAL EVALUATION AND MANAGEMENT OF PERITONITIS SECONDARY TO HOLLOW VISCUS PERFORATION
BACKGROUND Peritonitis is often caused by introduction of an infection into the otherwise sterile peritoneal environment through perforation of bowel, introduction of a chemically irritating material, such as g...
DEPRESSION, ANXIETY AND STRESS- A CROSS-SECTIONAL STUDY IN A COHORT OF SCHOOL STUDENTS FROM SOUTH INDIA
BACKGROUND The theme for the 2017 World Health Day campaign is Depression. WHO estimates that a total of 300 million people living in this world suffer from depression. Similar is the case of anxiety which affects 264 mi...
HEALTH SEEKING BEHAVIOUR AND REASONS FOR TUBERCULOSIS DIAGNOSIS DELAY AMONG POPULATIONS ATTENDING DOTS CELL AT TERTIARY HEALTH CARE TEACHING HOSPITAL
BACKGROUND Early diagnosis and treatment of Tuberculosis is crucial for reduction of infection rate and improving outcome of the treatment. Despite efforts made through media to sensitise community about the symptoms of...