Hemodialysis (HD) patients are at high risk for tuberculosis (TB), and a TST is not usually helpful in detecting TB infection because of anergic reactions. Prophylactic therapy against TB during dialysis is important to enhance transplantation success.
To evaluate the value of the TST in screening for TB and analyzing any compounding factors that might affect the results of the test in HD patients in an endemic area of Turkey. A total of 187 (96 female, 91 male) patients were screened using a 2-step TST. Test results were compared with clinical, radiologic, and laboratory data. None of patients had active TB during study and 55% had been vaccinated against TB. After the first PPD test, 55% of the patients showed a positive reaction, ultimately reaching a total of 68.4% following the second test. Cumulative positive TST results were significantly correlated with being male (P = .001, r = 0.352) and previous TB history (P = .013, r = 0.183); but there were no significant relationships between TST results and other data. Impairment of delayed-type hypersensitivity reaction is frequent in dialysis patients; we observed high rates of positivity with two-step- TST, which could be attributed to TB being endemic in Turkey. New techniques are needed to evaluate TB infection in dialysis patients and receive prophylactic therapy before transplantation.