透析患者の結核症 : 第4報肺結核発病り特性

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Dialysis patients are known to be immunodeficient. In attempting to clarify the characteristicsof development of pulmonary tuberculosis in the dialysis patients, an epidemiological study was done. The subjects were 7274 dialysis patients in 161 institutions including 150 patients withtuberculosis. Tuberculous lesions were documented in 137 patients. Among them 59 males and 26 females suffered from pulmonary tuberculosis; 45 males and 13 females had solely pulmonary tuberculous lesions, and 14 males and 13 females with pulmonary tuberculosis were accompanied withextrapulmonary tuberculous lesions. As to the causative diseases for renal failure, the frequencies of kidney tuberculosis, chronic pyelonephritis and polycystic kidney were higher among the patients with pulmonary tuberculosis accompanying extrapulmonary lesions than those among the patients with solely pulmonary lesions and thoseamong all other dialysis patients. The age-specific incidencies of pulmonary tuberculosis showed 2 peaks, one in the tens and anotherin the sixties of age. The age-specific incidence of pulmonary tuberculosis accompanying extrapulmonary lesions showed one peak in the forties. The pattern of the incidence was quite differentfrom each other.An increase of the incidence of pulmonary tuberculosis was observed 12 months before the initiation of dialysis therapy. The frequency became higher along with deterioration of kidney functionof the patients. The frequency reached the highest during the initial 3 months of dialysis therapy, then it came down along with the duration of dialysis therapy, although it remained higher than thatof the general population. Past history of tuberculosis was seen in 64% of tuberculosis patients developed during dialysisin whom past history was documented. Thus, the present study demonstrated a characteristic feature on the development of pulmonarytuberculosis in dialysis patients.
日本結核病学会の論文

透析患者の結核症 : 第4報肺結核発病り特性

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