Tuberculosis in renal transplant patients: the experience of a single center in Medellín-Colombia, 2005-2013

LMS Higuita, JF Nieto-Ríos… - Jornal Brasileiro de …, 2014 - SciELO Brasil
LMS Higuita, JF Nieto-Ríos, S Daguer-Gonzalez, C Ocampo-Kohn, A Aristizabal-Alzate
Jornal Brasileiro de Nefrologia, 2014SciELO Brasil
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 …
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.
SciELO Brasil