TUBERCULOSIS IN DIALYSIS PATIENTS

13. Findings Which Urged the Diagnosis

Abstract

Impaired host defense mechanisms are known in uremia. Signs, symptoms and labora tory findings in tuberculosis would reflect the altered host responses against the parasites. In order to clarify this point, a questionaire study was done. Study subjects were 92 male and 58 female dialysis patients with tuberculosis.
Fever, especially the one which is irresponsive to usual antibiotics was most common among the findings which urged the diagnosis of tuberculosis in dialysis patients. It was followed by chest roentgenography, cough, lymphnode swelling, general malaise, sputum, appetite loss, autopsy, accelerated ESR, weakness, pyuria, chest pain, weight loss, etc. In total, indefinite systemic symptoms were common and the local findings were rather limited with diminished pulmonary findings and relatively frequent extrapulmonary findings.
Patients with weight loss, weakness or appetite loss showed the highest fatality of 38% to 35%. Weight loss was accompanied by other signs, symptoms and laboratory findings at the highest frequency, being followed by weakness and appetite loss. Existence of these 3 symptoms and general malaise correlated well with each other. Presence of fever correlated moderately with the existence of these 4 symptoms. Acceralated ESR correlated with the development of the symptoms such as weakness, appetite loss, general malaise and night sweat. Positive chest roentgenographic findings were observed frequently in cases with weight loss and with sputum.