The relationship between lymphocyte subsets, nutritional status and tuberculin reactivity in continuous ambulatory peritonel dialysis and hemodialysis patients

Abstract

Background and Aims: Skin 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 purifed protein derivative (PPD) test response with demographical features, nutritional parameters and the distribution of peripheral blood lymphocyte subsets in peritoneal dialysis and hemodialysis patients. Method: Stable 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. Results: In 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 signifcant diferences in PPD reactivity (p<0.01). Albumin levels were signifcantly high in the control groups (p<0.01), and cholesterol levels were signifcantly high in the PD and the control groups (p<0.05). Transferrin levels were signifcantly high in the PD (p<0.01). The lymphocyte counts were signifcantly 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 signifcantly high in the PD groups (p<0.05). All the parameters were also similar between PPD-positive and -negative same groups. Conclusion: The 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.