Epidemiological Study of Tuberculous Pleuritis in Dialysis Patients

Abstract

Characteristics of tuberculosis with pleural lesion were studied epidemiologically in 7, 274 dialysis patients treated in 161 institutions.
Among them 14 males and 4 females were tuberculosis with pleural lesion. They were between 20s and 60s of age with the maximal age distribution at 50s. Three males and two females died from it. Tuberculosis with pleural lesion occupied 13% of all tuberculosis in dialysis patients. Tuberculous lesions were localized at pleura in a half of the cases. The other half with tuberculous pleuritis were accompanied by tuberculosis of other organs such as lung, peritoneum, kidney, spleen, liver, lymph node, bone etc. Incidences of tuberculosis with solely pleural lesion were 132 case/10⁵ persons·year in male and 70 in female. Incidences of tuberculous pleuritis coexisting with extrapleural tuberculosis were also 132 case/10⁵ persons ·year in male and 70 in female. Prognosis of tuberculosis with solely pleural lesion was good with no died case, however, that of pleural tuberculosis coexisting with extrapleural tuberculosis was serious with the fatality of 56%. Prognosis was worse in female than in male. Onsets of the disease were seen mostly between 3 months before and 18 months after the initiation of dialysis therapy. Sixtyseven percent of patients had a past history of tuberculosis. Organs involved in the past episode were again very often involved in the present tuberculosis. These facts can be interpreted that tuberculous pleuritis in dialysis patients develops frequently as a relapse of tuberculosis. Some causative diseases for renal failure like as uremic state also seem to affect the development of the tuberculosis. Patients with positive PPD skin test were less than a half of the tuberculosis patients.