Tuberculin positivity: A serious problem before transplantation in Turkey

Chronic renal failure (CRF) patients are at increased risk of tuberculosis. Detecting latent tuberculosis infection is essential before transplantation. The tuberculin skin test is the only validated method for the diagnosis of latent tuberculosis infection and for screening for hypersensitivity. The aim of this study was to assess the tuberculin test status (5 Todd units tuberculin) of 164 asymptomatic transplant candidates and correlate it with anamnestic data and laboratory values of patients awaiting transplantation. Skin test positivity was higher among older age subjects (r = .294, P = .0001). The cumulative prevalence rates of tuberculin positivity and anergy were 42.1% (69 patients) and 43.3% (71 patients), respectively. Only 14.5% of the positive patients had a previous tbc history; 15.9% had a family history of tbc. Among peritoneal dialysis (PD) patients, the rate of anergic skin tests was higher, while positivity was higher among patients who were preparing for preemptive renal transplantation (P = .009). In conclusion, there was a high prevalence of tuberculin positivity and anergy among asymptomatic pretransplant CRF patients. CRF patients who are awaiting transplantation especially should meet evaluations for previous tbc anamnesis and family history. Elderly subjects showed a higher risk for purified protein derivate positivity.