An update of management of latent tuberculosis infection and active disease in patients with chronic kidney disease

Myall, Katherine; Milburn, Heather

doi:10.20452/pamw.4093

Cited by 7 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They concluded that the incidence of anergy increased with the duration of dialysis. Delayed cutaneous hypersensitivity to microbial or protein antigens is commonly depressed in uremic patients (50-60%) compared to healthy controls [1,[3][4][5]10]. In our study, we found that the prevalence of PPD positivity in chronic HD and PD patients was %46.6 and %53.3, respectively.…”

Section: Discussionmentioning

confidence: 44%

“…Various T cell abnormalities have been demonstrated, but the data are conflicting and there are almost equal numbers of reports of normal and depressed T cell function. Uremic patients are always profoundly lymphopenic [5,6,13]. Significantly low absolute counts of the total population of T cells as well as T cell regulatory subsets and B cells have been described [14].…”

Section: Discussionmentioning

confidence: 99%

“…Various T cell abnormalities have been demonstrated, but the data are conflicting and there are almost equal numbers of reports of normal and depressed T cell function. The whole subset is beyond the scope of this communication [5][6][7]. In HD patients, decreased response to tuberculin, which is an anergic skin test, has been described.…”

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

The relationship between lymphocyte subsets, nutritional status and tuberculin reactivity in continuous ambulatory peritoneal dialysis and hemodialysis patients

et al. 2020

View full text Add to dashboard Cite

Aim Skin test anergy is common in patients with uremia and during maintenance hemodialysis treatment. However, up to date only one study concerning skin test in peritoneal dialysis patients has focused on the issue. Our cross-sectional controlled study was conducted to analyze the correlation of purified protein derivative (PPD) test response with demographical features, nutritional parameters and the distribution of peripheral blood lymphocyte subsets in peritoneal dialysis and hemodialysis patients Patients and methods Stable 30 hemodialysis (HD) patients (16 men, 14 women) and 30 continuous ambulatory peritoneal dialysis (PD) patients (17 men, 13 women) were included. Thirty healthy cases (15 men, 15 women) with a mean age of 32.4 ± 9.4 constituted the control group. Results In the HD group, 14 patients (46.6%) were PPD positive, and ın the PD group 16 patients (53.3%) were PPD positive. In the PPD-positive HD patients 64.2% (9/14), and in the PPD-positive PD patients 62.4% (10/16) had an induration of 10 mm or greater. In the control group, 21 of 30 patients (70%) were PPD positive. Comparison of both HD and PD groups with the control group showed significant differences in PPD reactivity (p < 0.01). Albumin levels were significantly high in the control groups (p < 0.01), and cholesterol levels were significantly high in the PD and the control groups (p < 0.05). Transferrin levels were significantly high in the PD (p < 0.01). The lymphocyte counts were significantly high in the control group compared to the HD patients (p < 0.05). The lymphocyte subset percentages CD19 were high in the control groups (p < 0.05), and CD16/56 was significantly high in the PD groups (p < 0.05). All the parameters were also similar between PPD-positive and-negative same groups. Conclusion The prevalence of PPD positivity was lower in the PD and HD groups. The PPD test responses were not related to the peripheral lymphocyte counts, subsets and malnutrition parameters.

show abstract

Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The relationship between lymphocyte subsets, nutritional status and tuberculin reactivity in continuous ambulatory peritoneal dialysis and hemodialysis patients

et al. 2020

View full text Add to dashboard Cite

show abstract

“…16 This is thought to be related to impaired cellular immunity associated with uremia. 17 When we investigated the factors associated with negative TST, we detected a statistically significant decrease in TST values of these patients who had an increased level of PTH and who received vitamin D treatment because of an increased PTH level. In the study conducted by Griveas et al, 34 patients undergoing HD was considered and two groups (normal and increased PTH levels) were compared and it was found that increased PTH caused changes in cellular immunity by affecting lymphocyte functions.…”

Section: Discussionmentioning

confidence: 91%

Factors affecting TST level in patients undergoing dialysis: a multicenter study

Deniz

Aydemir

Şengül

et al. 2018

Hemodialysis International

View full text Add to dashboard Cite

Introduction: The risk of TB is increased in patients with chronic kidney disease (CKD) when compared with individuals with normal renal function. We aimed to determine tuberculin skin test (TST) response and the factors which might affect the response in patients with CKD undergoing dialysis in this study. Methods: The purified protein derivative solution was administered to the patients and the diameter of induration was measured. Additionally, the age, gender and smoking status of the patients were interrogated. Comorbidities were recorded both by patients' self‐reports and data from the hospital files. The number of Bacille Calmette‐Guerin (BCG) scars was recorded by checking both shoulders. Findings: The study was conducted with a total of 371 patients (194 men and 177 women). The mean age was 60.09 ± 15.88, TST was 6.99 ± 6.9, duration of dialysis was 4.44 ± 4.5 (3.8–0.1,24). A total of 229 patients have comorbodities (61.7%, the most frequent was hypertension). Logistic regression model was performed. Gender, vitamin D treatment and high parathormone (PTH) levels remained in the final stage of the analysis and vitamin D intake and PTH levels were detected to be statistically significant (P = 0.002, 0.007, respectively). Discussion: This study is the first study which showed a correlation between TST negativity and increased PTH levels and receiving vitamin D treatment. Starting from this point, it was concluded that PTH may suppress the immune system and especially cellular immunity.

show abstract

“…This should be performed using IGRA or TST, depending on the availability of the test. The TST is associated with rates of cutaneous anergy of 50% in CKD patients due to poor immune responses (Myall and Milburn, 2017). The effect of CKD on IGRA results is not known, however a recent cost-effectiveness analysis has shown IGRA to be both more cost-effective and associated with better outcomes than testing strategies employing TST in patients with CKD (Campbell et al, 2019).…”

Section: Chronic Kidney Diseasementioning

confidence: 99%

Latent tuberculosis infection and non-infectious co-morbidities: Diabetes mellitus type 2, chronic kidney disease and rheumatoid arthritis

Ugarte-Gil

Carrillo‐Larco

Kirwan

2019

International Journal of Infectious Diseases

View full text Add to dashboard Cite

The prevalence of non-communicable diseases is increasing worldwide, which coincides with the persistence of infectious diseases including tuberculosis. These can synergistically affect individual and population health. Three non-communicable diseases that are relevant because of their associated morbidity, mortality and disability are type 2 diabetes mellitus, chronic kidney disease and rheumatoid arthritis. There is some evidence that patients with these conditions are at increased risk of acquiring latent tuberculosis infection (LTBI) and of this progressing to active disease. Unfortunately, evidence on accurate testing and effective prophylactic treatment in these populations is lacking. This review discusses current evidence and recommendations for management of LTBI in these patients.

show abstract

An update of management of latent tuberculosis infection and active disease in patients with chronic kidney disease

Cited by 7 publications

References 14 publications

The relationship between lymphocyte subsets, nutritional status and tuberculin reactivity in continuous ambulatory peritoneal dialysis and hemodialysis patients

The relationship between lymphocyte subsets, nutritional status and tuberculin reactivity in continuous ambulatory peritoneal dialysis and hemodialysis patients

Factors affecting TST level in patients undergoing dialysis: a multicenter study

Latent tuberculosis infection and non-infectious co-morbidities: Diabetes mellitus type 2, chronic kidney disease and rheumatoid arthritis

Contact Info

Product

Resources

About