Immunocompromised patients such as those with chronic renal failure requiring hemodialysis (HD) are at increased risk of developing tuberculosis(TB). For these reasons, routine TB screening of HD patients has been recommended. Although the Mantoux tuber-culin skin test remains the most useful screening tool, cutaneous anergy decreases the accuracy of the test. This study sought to evaluate current TB skin testing recommendations by examining the prevalence of tuberculin reactivity and anergy among HD patients as a kidney recipient and also in volunteer kidney donors. This study was performed prospectively on 108 kidney recipients and 108 kidney donors before transplantation between 2002- 2004. Patients were tuberculin tested using the Mantoux technique with 0.1 mL (5 tuberculin units) of purified protein derivative (PPD) intradermally injected into the volar surface of the forearm. . Results were interpreted 48- 72 h after injection. Areas of induration were measured with a fiberglass measuring tape and patients were divided to less than 10mm, 11- 15mm and more than 15mm induration. From 108 kidney recipient candidate on chronic dialysis 77 were male (71%) and 31 were female (29%) with average 36 year. Mean duration of dialysis was 3.5 year. PPD was positive in 25 kidney recipients before transplantation (23.1%). Tuberculin test was less than 10 mm in 4 patients (3.7%), 10-15 mm in 10 patients (9%), and more than 15mm in 11 kidney recipient candidate (10%). There wasn’t any significant correlation regarding to PPD results and sex, age, underling disorders and duration of dialysis. More than 90% of kidney donors were male in our study. About 78% of kidney donors were between 21-30 years old but only 30% of kidney recipients were between 21-30 years. Tuberculin test was positive in 13.8% of kidney donors. There wasn’t any HIV positive patients in our study. In conclusion, this study shows that there is a high rate of TB infection and anergy in patients on chronic dialysis. Despite the high rate of anergy, tuberculin testing remains a useful test in this population. Anergic patients require further clinical evaluation for TB. Other HD programs should tuberculin and anergy test their patients to determine prevalence tuberculosis in their populations.