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 100
- Downloads 0
THE ROLE OF WATERPROOFING LAYER IN SINGLE STAGE HYPOSPADIAS REPAIR: A PROSPECTIVE STUDY
[b] AIM:[/b] To study the comparative result of hypospadias repair by dividing the patients in two groups (a) hypospadias repair with waterproofing layer by one of the technique of hypospadias repair.(b) hypospa...
A STUDY TO EVALUATE THE ADVERSE REACTION OF TETANUS VACCINE (ADSORBED) IN HEALTHY INDIAN ADULTS
BACKGROUND Tetanus disease is one of the most dramatic and globally prevalent diseases of humans and vertebrate animals and has been reported for over 24 centuries. The manifestation of the disease, spastic paralysis, is...
SPLIT-COURSE ACCELERATED HYPERFRACTIONATED RADIOTHERAPY IN HEAD AND NECK CARCINOMA- AN EXPERIENCE IN TERMS OF LOCAL TUMOUR CONTROL AND TOXICITY
BACKGROUND Radiotherapy alone was long the standard nonsurgical therapy for locally advanced disease. A recent meta-analysis of randomised trial testing modified fractionation schemes against conventional once-daily frac...
BACTERIAL VAGINOSIS IN PRETERM LABOUR AT A TERTIARY CARE CENTRE
[b]INTRODUCTION[/b]: Bacterial Vaginosis is one of the important cause for pre-term labour which in turn can lead to infant mortality and morbidity, an easy and reliable Bacterial Vaginosis detection procedure...
INTRAVENOUS MIDAZOLAM - ROLE IN THE TREATMENT OF HYPERVENTILATION SYNDROME
[b]BACKGROUND[/b]: Hyperventilation syndrome (HVS) also known as irritable Heart, Da Costas syndrome or soldier’s heart is induced by stress. It comprises various symptoms like hyperventilation, breathlessness,...