BACKGROUND/AIM: Uremic patients are at an increased risk of being affected by tuberculosis (TB). Periodical tuberculin skin tests were suggested to detect TB-infected patients. These were replaced by chest radiographs in endemic areas like Taiwan. However, almost 50% of the TB incidence in dialysis patients was extrapulmonary. In this study, we tried to investigate the value of tuberculin tests in dialysis patients in endemic areas. METHODS: The patients were recruited from our dialysis unit. Purified protein derivative (PPD) and control tests with antigens for Candida and toxoid were performed using the Mantoux method. PPD with >10-mm induration will be considered positive. Skin anergy meant that the indurations of all antigens were less than 5 mm. A follow-up was done 12 months after the tests. RESULTS: A total of 177 patients were evaluated. Anergy was found in 40 patients (22.6%). A positive predictor of anergy was age >45 years (p = 0.03), while a negative predictor was prealbumin >20 mg/dl (p = 0.04). Fifty-three patients (30%) had positive PPD tests. Seven of the positive PPD patients (13.2%) developed active TB during the following years. Among the 40 patients with skin anergy, 6 (15%) were found to have active TB. Of the 48 patients (21.1%) with indurations of the PPD tests between 5 and 10 mm, none was found to have active TB. CONCLUSION: Although anergy will influence the sensitivity of PPD tests, these tests in combination with anergy tests could help to establish the diagnosis of TB in uremic patients, even in TB-endemic areas. Copyright 2002 S. Karger AG, Basel
BACKGROUND/AIM: Uremic patients are at an increased risk of being affected by tuberculosis (TB). Periodical tuberculin skin tests were suggested to detect TB-infectedpatients. These were replaced by chest radiographs in endemic areas like Taiwan. However, almost 50% of the TB incidence in dialysis patients was extrapulmonary. In this study, we tried to investigate the value of tuberculin tests in dialysis patients in endemic areas. METHODS: The patients were recruited from our dialysis unit. Purified protein derivative (PPD) and control tests with antigens for Candida and toxoid were performed using the Mantoux method. PPD with >10-mm induration will be considered positive. Skin anergy meant that the indurations of all antigens were less than 5 mm. A follow-up was done 12 months after the tests. RESULTS: A total of 177 patients were evaluated. Anergy was found in 40 patients (22.6%). A positive predictor of anergy was age >45 years (p = 0.03), while a negative predictor was prealbumin >20 mg/dl (p = 0.04). Fifty-three patients (30%) had positive PPD tests. Seven of the positive PPD patients (13.2%) developed active TB during the following years. Among the 40 patients with skin anergy, 6 (15%) were found to have active TB. Of the 48 patients (21.1%) with indurations of the PPD tests between 5 and 10 mm, none was found to have active TB. CONCLUSION: Although anergy will influence the sensitivity of PPD tests, these tests in combination with anergy tests could help to establish the diagnosis of TB in uremic patients, even in TB-endemic areas. Copyright 2002 S. Karger AG, Basel
Authors: Jens Van Praet; Marijke Reynders; Dirk De Bacquer; Liesbeth Viaene; Melanie K Schoutteten; Rogier Caluwé; Peter Doubel; Line Heylen; Annelies V De Bel; Bruno Van Vlem; Deborah Steensels; An S De Vriese Journal: J Am Soc Nephrol Date: 2021-09-29 Impact factor: 10.121
Authors: Antonios I Christopoulos; Athanasios A Diamantopoulos; Panagiotis A Dimopoulos; Demetrios S Goumenos; George A Barbalias Journal: BMC Nephrol Date: 2009-11-07 Impact factor: 2.388