Tuberculin and anergy skin testing of patients receiving long-term hemodialysis

Study objectives: Immunocompromised patients with chronic renal failure requiring hemodialysis (HD) are at increased risk of developing tuberculosis (TB). Routine TB screening of this population is recommended. This study examined the frequency of TB reactions and anergy in HD patients in a community with a high prevalence of TB. Design: Outpatients in a hospital- based HD center were screened with tuberculin, Candida, and mumps antigen. Results: Forty percent of patients were anergic and 19% were tuberculin reactors. No demographic factors correlated with either test results. Conclusions: There was a high rate of TB infection and anergy in this HD center. 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 in their populations.