Clinical Features And Prognosis Of Active Tuberculosis Patients Under Hemodialisis

Objective: The aim of this study is to investigate the clinical features,diagnosis,treatment and prognosis of active MTB infection in patients undergoing HD.Methods: The clinical data of 36 HD patients with active TB infection from Jan 1 2014 to Jan 1 2018 in our hospital were studied retrospectively.The survival curves were drawn using Kaplan-Meier method,and univariate analysis was performed by the Log-rank test.Results: The male-to-female ratio was 2.36.The average age of 36 HD patients was(48.58±14.3)years old,the median interval between the onset of HD and the time of the diagnosis of TB was 14 months,and the median duration of symptom onset to diagnosis was 52 days.Most patients presented with fever(58.33%)and extra-pulmonary TB(72.22%).The bacteriological confirmation was made in 22.22% and histological confirmation was made in 25.00%,and in the rest,the diagnosis was depended on the manifestation and auxiliary examination.Thirty-six patients were treated with antituberculotics.The adverse effects of anti-TB drugs were developed in 19(52.78%),peripheral neuropathy,retrobulbarneuritis and digestive disorders were common.The follow-up was 3 days to48 months.Besides,eleven patients(30.56%)died,univariate analysis showed that ALB<35 g/L(P=0.011)and age?60-year-old(P<0.005)were related to prognosis.Conclusion: Among HD patients with active TB infection,there was no specific manifestation,making a diagnosis of TB was difficult,the adverse effects of anti-TB drugs were common than general population and the prognosis was poor.Nutritional status and age could be crucial risk factors that affected the prognosis.