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Title: The value of tuberculin skin testing in haemodialysis patients
Authors: Wauters, Anne
Peetermans, Willy
Van den Brande, Paul
De Moor, B
Evenepoel, Pieter
Keuleers, Hilde
Kuypers, Dirk
Stas, Koen
Vanwalleghem, Johan
Vanrenterghem, Yves
Maes, Bart #
Issue Date: Jan-2004
Series Title: Nephrology, Dialysis, Transplantation vol:19 issue:2 pages:433-8
Abstract: BACKGROUND: Chronic haemodialysis patients are at increased risk for developing tuberculosis (TB). Appropriate screening methods to detect latent Mycobacterium tuberculosis infection are required. The aim of this prospective multi-centre study was to evaluate the tuberculin skin test (TST) as a screening method for detection of M.tuberculosis infection in haemodialysis patients. METHODS: A total of 224 patients in two haemodialysis centres were prospectively tested, using 2 units of tuberculin PPD RT23. Up to three booster injections were given with a 7 day interval to patients not responding to the previous test. The results were compared with clinical and radiological data. RESULTS: The cumulative prevalence of a positive TST was 14.7% for the first test, 27.8% for the second test and 32.6% for the fourth test. There was no influence of age, gender, haemodialysis centre, dialysis efficiency, nutritional state, levels of zinc, vitamin D therapy, primary renal disease, (previous or active) immunosuppressive therapy or response to hepatitis B vaccination. There was a significant, but weak, correlation between TST positivity and a history of positive TST or TB. Chest radiography and positive TST were not correlated, yet a positive chest X-ray increased the detection of patients with latent M.tuberculosis infection up to 47.8%. CONCLUSIONS: In haemodialysis patients, a positive response of >30% to repeated TST was obtained. Two consecutive TSTs were sufficient to recruit most of the booster reactions. Since only a weak correlation was found with anamnestic data, regular TST evaluation in combination with a chest X-ray, is a useful tool to detect infection with M.tuberculosis in haemodialysis patients.
URI: 
ISSN: 0931-0509
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Nephrology
Laboratory for Clinical Infectious and Inflammatory Disorders
# (joint) last author

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