Journal Article

The value of tuberculin skin testing in haemodialysis patients

Anne Wauters, Willy E. Peetermans, Paul Van den Brande, Bart De Moor, Pieter Evenepoel, Hilde Keuleers, Dirk Kuypers, Koen Stas, Johan Vanwalleghem, Yves Vanrenterghem and Bart D. Maes

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 19, issue 2, pages 433-438
Published in print February 2004 | ISSN: 0931-0509
Published online February 2004 | e-ISSN: 1460-2385 | DOI:
The value of tuberculin skin testing in haemodialysis patients

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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.

Keywords: haemodialysis; tuberculin skin test; tuberculosis

Journal Article.  3250 words.  Illustrated.

Subjects: Nephrology

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