| Theme | Complications of Respiratory Organs in Dialysis Patients | |
|---|---|---|
| Title | Tuberculosis in hemodialysis patients | |
| Publish Date | 2008/07 | |
| Author | Hitoshi Nakayama | Shinrakuen Hospital |
| Author | Tai Sakurabayashi | Shinrakuen Hospital |
| Author | Shigeru Miyazaki | Shinrakuen Hospital |
| Author | Shinji Sakai | Shinrakuen Hospital |
| Author | Masashi Suzuki | Shinrakuen Hospital |
| Author | Ikuo Aoike | Koyo Medical Clinic |
| [ Summary ] | End-stage renal failure patients receiving chronic dialysis are at high risk for tuberculosis due to attenuated cellular immunity. The number of patients with tubercular complications has decreased. However many long term dialysis patients also had extra-pulmonary tuberculosis. Bacterial examinations (smear and culture) provide accurate and fast diagnoses. However, it is difficult to diagnose cases of extra-pulmonary tuberculosis. Chemoprophylaxis is important for chronic dialysis patients to prevent tuberculosis. Treatment of latent tuberculosis infection is necessary. Accurate tests for tuberculosis are needed. The QuantiFERON (QFT) -2G test is not influenced by BCG vaccination or infection by atypical mycobacteria. The sensitivity and specificity of the QFT-2G test ranges from 89.0 % to 98.1 %. The QFT-2G test will become a useful diagnostic tool. Management of active pulmonary tuberculosis for those undergoing hemodialysis is important. However, the number of hospitals which are capable of taking care of such patients is estimated to be low in Japan at this time. |
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