The Affecting Factors and Comparison of Tuberculin Skin Test in Peritoneal Dialysis and Hemodialysis Patients

Abstract

Compared with the general population, patients with chronic renal failure have increased tuberculosis (TB) prevalence and mortality rates. In this study, we aimed to investigate tuberculin skin test (TST) positivity rates in hemodialysis (HD) and peritoneal dialysis (PD) patients and the factors influencing TST positivity. Ninety-two HD patients and 44 PD patients who had been on HD and PD treatment for at least 3 months were recruited into the study. TST was administered in all patients. Positivity was defined as an induration diameter >10 mm. At least 5 mm of induration following skin testing together with a chest radiography indicating previous infection was defined as latent TB infection. TST positivity rates, diameter of TST indurations, and serum albumin levels in HD patients were higher than the PD patients. TST induration size was not correlated with any other parameters in both HD and PD groups. TST-positive patients had higher albumin levels and lower leukocyte count than the TST-negative patients. In TST-positive patients, albumin level was correlated with the duration of dialysis but TST induration size was not correlated with the lymphocyte count and albumin level. In our study, TST positivity of patients was found in 30.4% of HD patients, 9% of PD patients, and 23.5% of total patients. It is still recommended to use TST for the screening test of TB. We found a significant relationship between TST and albumin level. It should be remembered that TST response may be lower in PD patients, especially in cases in which TB is suspected.

Comparison of the Prevalence of Latent Tuberculosis Infection among Non-Dialysis Patients with Severe Chronic Kidney Disease, Patients Receiving Dialysis, and the Dialysis-Unit Staff: A Cross-Sectional Study

“…This further suggests that the incidence of active TB is also higher in the elderly. High serum albumin level is considered a good nutritional status that can provide good immune reactivity for LTBI assay [ 35 , 36 ]. In the present study, although those with past treatment history of active TB have been excluded, chest radiographs of prior TB lesions are still a significant factor, possibly because radiography is more reliable.…”

Tuberculin Skin Test and Boosted Reactions among Newly Employed Healthcare Workers: An Observational Study

“…Nevertheless, our study showed that being older, male, rejoining the hospital workforce, and having a previous history of TB were associated with TST positivity, although there were slight differences according to the period due to the small discrepancy in baseline characteristics during the one-step and two-step periods. Cristopoulos et al and Altunoren et al reported that older age is a risk factor for TB [12], [13]. Jimenez-Corona et al reported that there may be sex-related differences in incidence rates of TB in the general population due to the dynamics of local spread or the degree of environmental exposure [14].…”