Böbrek nakli alıcı adaylarında diyaliz tipinin tüberkülin deri testi üzerine etkisinin karşılaştırılması
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Date
2013-01-25
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Uludağ Üniversitesi
Abstract
Tüberkülin deri testi (PPD), tüberküloz (TB) insidensinin belirlenmesinde değerli bir yöntemdir. Ancak, diyaliz hastalarında hücresel immü nitenin bozulması PPD’nin tanısal değerini azaltmaktadır. Bu retrospektif çalışmada böbrek nakli adayı prediyaliz veya diyaliz hastalarında nakil öncesi PPD yanıtının karşılaştırılması amaçlanmıştır. Toplam 116 ardışık alıcı adayı çalışmaya dahil edildi. Tüm hastalara nakil öncesi PPD testi Mantoux yöntemi ile yapıldı. Hastaların yaş ortalaması 35 idi. Kadın/erkek dağılımı 72/44 idi. 25 (%22) hasta prediyaliz iken, 62 (%53) hastaya hemodiyaliz (HD) ve 29 (%25) hastaya periton diyalizi (PD) uygulanmaktaydı. 33 (%53) HD, 12 (%40) PD ve 14 (%36) prediyaliz olmak üzere 59 (%50) hastada PPD anerjikti. Endürasyon çapı tüm gruplarda ortalama 6 mm olarak bulundu. Farklı diyaliz moda liteleri kullanan hastalar ve preemptif grup arasında anerji ve endurasyon oranları arasında bir fark saptanmadı. Sonuç olarak çalışmamızın bulgularına göre diyaliz tipi PPD yanıtını etkilememektedir. Bu hastalarda yüksek insidense sahip TB, nakil öncesi daha duyarlı ve özgül testlerle araştırılmalıdır.
Tuberculin skin test (PPD) is a valuable method to determine the incidence of tuberculosis (TB). However, disruption of cellular immunity in dialysis patients reduces the diagnostic value of the PPD. This retrospective study aimed to compare PPD response in predialysis and dialysis patients before kidney transplantation. A total of 116 patients were included in the study. PPD was performed by the method of Mantoux to all patients. The average age of the patients was 35. Female/male ratio was 72/44. 29 (25%) were on peritoneal dialysis (PD), 62 (53%) were on hemodialysis (HD), and 25 (22%) were predialysis patients. About 33 (53%) of HD, 12 (40%) of PD and 14 (36%) of predialysis patients showed PPD anergy. An average of 6 mm in diameter of induration was found in all groups. There was no difference between the two groups regarding diameter of induration and anergy rate. In conclusion, dialysis modality did not affect the response to PPD. Because of the high incidence of TB after kidney transplantation, TB should be sought with more sensitive and specific tests in end stage renal disease.
Tuberculin skin test (PPD) is a valuable method to determine the incidence of tuberculosis (TB). However, disruption of cellular immunity in dialysis patients reduces the diagnostic value of the PPD. This retrospective study aimed to compare PPD response in predialysis and dialysis patients before kidney transplantation. A total of 116 patients were included in the study. PPD was performed by the method of Mantoux to all patients. The average age of the patients was 35. Female/male ratio was 72/44. 29 (25%) were on peritoneal dialysis (PD), 62 (53%) were on hemodialysis (HD), and 25 (22%) were predialysis patients. About 33 (53%) of HD, 12 (40%) of PD and 14 (36%) of predialysis patients showed PPD anergy. An average of 6 mm in diameter of induration was found in all groups. There was no difference between the two groups regarding diameter of induration and anergy rate. In conclusion, dialysis modality did not affect the response to PPD. Because of the high incidence of TB after kidney transplantation, TB should be sought with more sensitive and specific tests in end stage renal disease.
Description
Türkiye Organ Nakli Kuruluşları Koordinasyon Derneği IX. Kongresi: Transplantasyon 2012 (26-29 Eylül 2012) Kongresi’nde tebliğ edilmiştir.
Keywords
Tüberküloz, Hücresel immunite, Kronik böbrek yetmezliği, Diyaliz, PPD testi, Tuberculosis, Cellular immunity, Chronic renal failure, Dialysis, PPD test
Citation
Ersoy, A. vd. (2013). "Böbrek nakli alıcı adaylarında diyaliz tipinin tüberkülin deri testi üzerine etkisinin karşılaştırılması". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 39(1), 45-47.