Tuberculosis in Peritoneal Dialysis patients: A Diagnostic challenge.

Introduction: Tuberculosis (TB) is a common infectious illness in people with chronic kidney disease (CKD).Peritoneal localization, which is generally uncommon, has become a significant form in peritoneal dialysis patients.Positive diagnosis is challenging in this population due to the non-specific clinical presentation. Material and Methods:From 2014 to 2021, we included all patients on peritoneal dialysis who had been treated for TB in the nephrology department of the HASSAN II university hospital of Fez.The goal of our investigation is to describe clinical and paraclinical presenting patterns, methods used to maintain the diagnosis, and treatment outcomes in order to raise the diagnostic challenge of tuberculosis in this group. Results:We found five cases out of 125 incident patients.One patient had lymph node involvement, while four others had peritoneal involvement.The patients' average age was 31.9 ± 11.9 years (20-50 years), including two females.Clinically, four individuals experienced a change in their overall condition as well as stomach discomfort.Three patients had a protracted fever, and one patient had extensive joint discomfort.All of the patients suffered from lymphopenia and a biological inflammatory condition.A CT scan of the abdomen revealed a compartmentalized effusion in two individuals, one of whom had deep adenopathies and the other had calcified adenopathies.The involvement was kept due to the rapid detection of MYCOBACTERIUM TUBERCULOSIS DNA by molecular biology test (GeneXpert®) in the peritoneal fluid of three patients, on lymph node biopsy, which revealed tuberculous adenitis in one patient and a positive adenosine desaminase assay in the fifth patient.Four patients were diagnosed with TB within one year of starting peritoneal dialysis, while the fifth patient was diagnosed three years later.According to the RHZE/RH regimen, all patients received antituberculosis medication for 6 to 9 months (R: Rifampicin, H: Isoniazid, Z: Pyrazinamide, and E: Ethambutol).All patients had remission with the removal of the catheter and the conversion to hemodialysis.