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Tuberculosis in renal transplant patients: The experience of a single center in Medellín-Colombia, 2005-2013
- Source :
- Brazilian Journal of Nephrology, Vol 36, Iss 4, Pp 512-518 (2014)
- Publication Year :
- 2014
- Publisher :
- Sociedade Brasileira de Nefrologia, 2014.
-
Abstract
- Introduction: Tuberculosis is a common opportunistic infection in renal transplant patients. Objective: To obtain a clinical and laboratory description of transplant patients diagnosed with tuberculosis and their response to treatment during a period ranging from 2005 to 2013 at the Pablo Tobón Uribe Hospital. Methods: Retrospective and descriptive study. Results: In 641 renal transplants, tuberculosis was confirmed in 12 cases. Of these, 25% had a history of acute rejection, and 50% had creatinine levels greater than 1.5 mg/dl prior to infection. The disease typically presented as pulmonary (50%) and disseminated (33.3%). The first phase of treatment consisted of 3 months of HZRE (isoniazid, pyrazinamide, rifampicin and ethambutol) in 75% of the cases and HZME (isoniazid, pyrazinamide, moxifloxacin and ethambutol) in 25% of the cases. During the second phase of the treatment, 75% of the cases received isoniazid and rifampicin, and 25% of the cases received isoniazid and ethambutol. The length of treatment varied between 6 and 18 months. In 41.7% of patients, hepatotoxicity was associated with the beginning of anti-tuberculosis therapy. During a year-long follow-up, renal function remained stable, and the mortality rate was 16.7%. Conclusion: Tuberculosis in the renal transplant population studied caused diverse nonspecific symptoms. Pulmonary and disseminated tuberculosis were the most frequent forms and required prolonged treatment. Antituberculosis medications had a high toxicity and mortality. This infection must be considered when patients present with a febrile syndrome of unknown origin, especially during the first year after renal transplant.
Details
- Language :
- English, Portuguese
- ISSN :
- 21758239 and 01012800
- Volume :
- 36
- Issue :
- 4
- Database :
- Directory of Open Access Journals
- Journal :
- Brazilian Journal of Nephrology
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.f82361229a3e4c5b8d9e8ee48b3b12ae
- Document Type :
- article
- Full Text :
- https://doi.org/10.5935/0101-2800.20140073