Lundin A P, Adler A J, Berlyne G M, Friedman E A
Am J Med. 1979 Oct;67(4):597-602. doi: 10.1016/0002-9343(79)90240-7.
Tuberculosis was diagnosed in eight patients undergoing maintenance hemodialysis and occurred with an incidence 10 times that of the general population. Dialysis-associated tuberculosis is characterized by intermittent fever, anorexia, weight loss and hepatomegaly. Ascites was present in 50 per cent of the patients. A recently converted positive tuberculin skin test was observed in five of eight patients. Tuberculosis was extrapulmonary in seven of eight cases and consequently the diagnosis was frequently delayed. Over-all mortality was 37.5 per cent and correlated with the duration of symptoms prior to initiation of therapy. A trial of antituberculous therapy is warranted in patients undergoing dialysis in whom fever of unknown origin, anorexia, weight loss and/or hepatomegaly develop particularly in areas endemic for tuberculosis.
在8例维持性血液透析患者中诊断出结核病，其发病率是普通人群的10倍。透析相关结核病的特征为间歇性发热、厌食、体重减轻和肝肿大。50%的患者出现腹水。8例患者中有5例结核菌素皮肤试验近期转为阳性。8例中有7例为肺外结核，因此诊断常常延迟。总体死亡率为37.5%，且与开始治疗前症状持续时间相关。对于接受透析且出现不明原因发热、厌食、体重减轻和/或肝肿大的患者，尤其是在结核病流行地区，应进行抗结核治疗试验。
