Department of Nephrology, Faculty of Medicine, Kahramanmaraş Sutcu Imam University, Kahramanmaras, Turkey.
Ren Fail. 2012;34(3):304-7. doi: 10.3109/0886022X.2011.647299. Epub 2012 Jan 20.
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.
与一般人群相比,慢性肾衰竭患者的结核病(TB)患病率和死亡率均较高。本研究旨在探讨血液透析(HD)和腹膜透析(PD)患者结核菌素皮肤试验(TST)阳性率及其影响因素。本研究共纳入 92 例 HD 患者和 44 例 PD 患者,他们均接受 HD 和 PD 治疗至少 3 个月。所有患者均进行 TST。硬结直径>10mm 定义为阳性。硬结直径至少增加 5mm 且胸片提示既往感染定义为潜伏性 TB 感染。HD 患者的 TST 阳性率、TST 硬结直径和血清白蛋白水平均高于 PD 患者。HD 和 PD 组中 TST 硬结大小与其他任何参数均无相关性。TST 阳性患者的白蛋白水平高于 TST 阴性患者,白细胞计数低于 TST 阴性患者。在 TST 阳性患者中,白蛋白水平与透析时间有关,但 TST 硬结大小与淋巴细胞计数和白蛋白水平无关。在本研究中,HD 患者、PD 患者和总患者的 TST 阳性率分别为 30.4%、9%和 23.5%。仍建议使用 TST 进行 TB 筛查试验。我们发现 TST 与白蛋白水平之间存在显著关系。应记住,TST 反应可能在 PD 患者中较低,尤其是在怀疑 TB 时。