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Male–female differences in the risk of tuberculosis in dialysis patients

  • Nephrology - Original Paper
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Abstract

Aim

To define any gender-related differences in the prevalence and risk for tuberculosis (TB) in hemodialysis (HD) patients.

Methods

All active TB cases were recorded during a 36-month follow-up of 272 (193 male and 79 female) HD patients. Entering the study, HD patients were tested with tuberculin and 2,4-dinitrochlorobenzene, and a cell-mediated immunity (CMI) index was estimated. Relative risks (RR) for TB were calculated considering subjects from the background general population as a reference group. The independent effect of age, BMI and tuberculin sensitivity was determined using Cox’s proportional hazard model.

Results

Female HD patients presented significantly lower CMI indices and rates of positive Mantoux tests, but higher rates of DM, as compared to males. The male:female ratio in TB for the general and HD patients population was 1.8 and 0.6, respectively. There was a significantly lower TB prevalence in male as compared to female HD patients (7.7% vs. 11.3%), and a subsequent female predominance in risk for TB in those HD patients aged <49 and 50–69 years (M:F adjusted relative risk 0.67 and 0.53) was recorded.

Conclusions

In contrast to the general population, there is a female predominance among dialysis TB patients younger than 70 years associated with the coexistence of DM. Female gender should always be considered as a risk factor when evaluating diabetic HD patients for active TB.

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Authors and Affiliations

  1. Department of Nephrology of “St. Andrew” General State Hospital, University Hospital Rio, Patra, Greece

    A. I. Christopoulos & A. A. Diamantopoulos

  2. Department of Radiology, University Hospital Rio, Patra, Greece

    P. A. Dimopoulos

  3. Department of Nephrology, University Hospital Rio, Patra, Greece

    D. S. Goumenos

  4. Department of Urology, University Hospital Rio, Patra, Greece

    G. A. Barbalias

  5. School Of Medicine, University of Patras, University Hospital Rio, Patra, 26 221, Greece

    A. I. Christopoulos

Authors
  1. A. I. Christopoulos
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  2. A. A. Diamantopoulos
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  3. P. A. Dimopoulos
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  4. D. S. Goumenos
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  5. G. A. Barbalias
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Correspondence to A. I. Christopoulos.

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Christopoulos, A.I., Diamantopoulos, A.A., Dimopoulos, P.A. et al. Male–female differences in the risk of tuberculosis in dialysis patients. Int Urol Nephrol 41, 671–677 (2009). https://doi.org/10.1007/s11255-008-9479-8

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  • DOI: https://doi.org/10.1007/s11255-008-9479-8

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