Diagnosis and management of tuberculosis in peritoneal dialysis

Infectious complications represent the second cause of death in chronic renal failure, in particular tuberculosis (Tb), which remains more frequent in dialysis patients. The aim of our work is to determine the prevalence of Tb in our patients on peritoneal dialysis (PD) and to analyze the clinical,...

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Main Authors: Latifa Driouch, Safae Boughlala, Ouafae Assal, Naima Ouzeddoun, Rabia Bayahia, Loubna Benamar
Format: Article
Language:English
Published: RDPLF 2023-04-01
Series:Bulletin de la Dialyse à Domicile
Subjects:
Online Access:https://bdd.rdplf.org/index.php/bdd/article/view/76633
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author Latifa Driouch
Safae Boughlala
Ouafae Assal
Naima Ouzeddoun
Rabia Bayahia
Loubna Benamar
author_facet Latifa Driouch
Safae Boughlala
Ouafae Assal
Naima Ouzeddoun
Rabia Bayahia
Loubna Benamar
author_sort Latifa Driouch
collection DOAJ
description Infectious complications represent the second cause of death in chronic renal failure, in particular tuberculosis (Tb), which remains more frequent in dialysis patients. The aim of our work is to determine the prevalence of Tb in our patients on peritoneal dialysis (PD) and to analyze the clinical, paraclinical and evolutionary profile of this infection. This is a retrospective cross-sectional study, including PD patients diagnosed with Tb. We analyzed their clinical and paraclinical profile, the diagnosis and localization of Tb, as well as the evolution under treatment. We retained 12 cases of Tb among the 228 patients followed in PD (5.26%) from 2006 to 2022, with an M/F sex ratio of 0.7 and an average age of 52.7 ± 10 years. The median time between the start of PD and the diagnosis of Tb was 21 months [5 - 37]. The diagnosis of Tb was retained with certainty in 7 cases, based on bacteriological and/or histological evidence. The diagnosis was presumptive in 5 cases on a bundle of clinical and paraclinical arguments. The localization of Tb is pulmonary in 4 cases and extra-pulmonary in 8 cases including 3 cases of tuberculous peritonitis. Anti-bacillary treatment is started after a median delay of 20 days [9-37] after the onset of symptoms. This treatment was complicated by 2 cases of drug-induced hepatitis and 1 case of polyneuritis. The evolution is marked by healing in 11 patients. Regarding tuberculous peritonitis, the catheter was removed in one patient and maintained in the other two cases with favorable outcome. In PD, the diagnosis of Tb is often difficult and extra-pulmonary involvement is more frequent.
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spelling doaj.art-6042363b31a84677a75b35b9de43c4482023-05-04T23:13:24ZengRDPLFBulletin de la Dialyse à Domicile2607-99172023-04-0161253410.25796/bdd.v6i1.7663390763Diagnosis and management of tuberculosis in peritoneal dialysisLatifa Driouch0Safae Boughlala1Ouafae Assal2Naima Ouzeddoun3Rabia Bayahia4Loubna Benamar5Service de Néphrologie-Dialyse-Transplantation Rénale, CHU Ibn Sina – Rabat Université Mohammed V, Rabat, MAROCService de Néphrologie-Dialyse-Transplantation Rénale, CHU Ibn Sina – RabatService de Néphrologie-Dialyse-Transplantation Rénale, CHU Ibn Sina – RabatService de Néphrologie-Dialyse-Transplantation Rénale, CHU Ibn Sina – RabatService de Néphrologie-Dialyse-Transplantation Rénale, CHU Ibn Sina – RabatService de Néphrologie-Dialyse-Transplantation Rénale, CHU Ibn Sina – RabatInfectious complications represent the second cause of death in chronic renal failure, in particular tuberculosis (Tb), which remains more frequent in dialysis patients. The aim of our work is to determine the prevalence of Tb in our patients on peritoneal dialysis (PD) and to analyze the clinical, paraclinical and evolutionary profile of this infection. This is a retrospective cross-sectional study, including PD patients diagnosed with Tb. We analyzed their clinical and paraclinical profile, the diagnosis and localization of Tb, as well as the evolution under treatment. We retained 12 cases of Tb among the 228 patients followed in PD (5.26%) from 2006 to 2022, with an M/F sex ratio of 0.7 and an average age of 52.7 ± 10 years. The median time between the start of PD and the diagnosis of Tb was 21 months [5 - 37]. The diagnosis of Tb was retained with certainty in 7 cases, based on bacteriological and/or histological evidence. The diagnosis was presumptive in 5 cases on a bundle of clinical and paraclinical arguments. The localization of Tb is pulmonary in 4 cases and extra-pulmonary in 8 cases including 3 cases of tuberculous peritonitis. Anti-bacillary treatment is started after a median delay of 20 days [9-37] after the onset of symptoms. This treatment was complicated by 2 cases of drug-induced hepatitis and 1 case of polyneuritis. The evolution is marked by healing in 11 patients. Regarding tuberculous peritonitis, the catheter was removed in one patient and maintained in the other two cases with favorable outcome. In PD, the diagnosis of Tb is often difficult and extra-pulmonary involvement is more frequent.https://bdd.rdplf.org/index.php/bdd/article/view/76633peritoneal dialysisperitonitistuberculosisanti-bacillary
spellingShingle Latifa Driouch
Safae Boughlala
Ouafae Assal
Naima Ouzeddoun
Rabia Bayahia
Loubna Benamar
Diagnosis and management of tuberculosis in peritoneal dialysis
Bulletin de la Dialyse à Domicile
peritoneal dialysis
peritonitis
tuberculosis
anti-bacillary
title Diagnosis and management of tuberculosis in peritoneal dialysis
title_full Diagnosis and management of tuberculosis in peritoneal dialysis
title_fullStr Diagnosis and management of tuberculosis in peritoneal dialysis
title_full_unstemmed Diagnosis and management of tuberculosis in peritoneal dialysis
title_short Diagnosis and management of tuberculosis in peritoneal dialysis
title_sort diagnosis and management of tuberculosis in peritoneal dialysis
topic peritoneal dialysis
peritonitis
tuberculosis
anti-bacillary
url https://bdd.rdplf.org/index.php/bdd/article/view/76633
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AT safaeboughlala diagnosisandmanagementoftuberculosisinperitonealdialysis
AT ouafaeassal diagnosisandmanagementoftuberculosisinperitonealdialysis
AT naimaouzeddoun diagnosisandmanagementoftuberculosisinperitonealdialysis
AT rabiabayahia diagnosisandmanagementoftuberculosisinperitonealdialysis
AT loubnabenamar diagnosisandmanagementoftuberculosisinperitonealdialysis