Abstract

AimSkin test anergy is common in patients with uremia and during maintenance hemodialysis treatment. However, up to date only one study concerning skin test in peritoneal dialysis patients has focused on the issue. Our cross-sectional controlled study was conducted to analyze the correlation of purified protein derivative (PPD) test response with demographical features, nutritional parameters and the distribution of peripheral blood lymphocyte subsets in peritoneal dialysis and hemodialysis patientsPatients and methodsStable 30 hemodialysis (HD) patients (16 men, 14 women) and 30 continuous ambulatory peritoneal dialysis (PD) patients (17 men, 13 women) were included. Thirty healthy cases (15 men, 15 women) with a mean age of 32.4 ± 9.4 constituted the control group.ResultsIn the HD group, 14 patients (46.6%) were PPD positive, and ın the PD group 16 patients (53.3%) were PPD positive. In the PPD-positive HD patients 64.2% (9/14), and in the PPD-positive PD patients 62.4% (10/16) had an induration of 10 mm or greater. In the control group, 21 of 30 patients (70%) were PPD positive. Comparison of both HD and PD groups with the control group showed significant differences in PPD reactivity (p < 0.01). Albumin levels were significantly high in the control groups (p < 0.01), and cholesterol levels were significantly high in the PD and the control groups (p < 0.05). Transferrin levels were significantly high in the PD (p < 0.01). The lymphocyte counts were significantly high in the control group compared to the HD patients (p < 0.05). The lymphocyte subset percentages CD19 were high in the control groups (p < 0.05), and CD16/56 was significantly high in the PD groups (p < 0.05). All the parameters were also similar between PPD-positive and -negative same groups.ConclusionThe prevalence of PPD positivity was lower in the PD and HD groups. The PPD test responses were not related to the peripheral lymphocyte counts, subsets and malnutrition parameters.

Highlights

  • It is known that an immune deficiency state is observed in chronic hemodialysis (HD) patients due to unknown mechanisms [1]

  • We found that the prevalence of purified protein derivative (PPD) positivity in chronic HD and peritoneal dialysis (PD) patients was %46.6 and %53.3, respectively

  • The PPD positivity rates of these two groups were similar as well as the total dialysis duration. Both the HD and PD groups had significantly lower PPD positivity rates compared to the control groups

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Summary

Introduction

It is known that an immune deficiency state is observed in chronic hemodialysis (HD) patients due to unknown mechanisms [1]. Both humoral and cellular immune systems have functional impairment in this setting. The major defect is generally detected in the cellular immune system in which T-lymphocytes have an important role [2]. Defective cell-mediated immunity, as reflected by anergy to multiple skin test antigens, is well documented in patients with protein-calorie malnutrition [3]. Skin test anergy is common in patients with uremia and during maintenance hemodialysis treatment [4].

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