Nalan AKALIN, Feride SAPMAZ, Pervaneh ŞEBER

Hemodiyalize giren kronik böbrek yetmezlıkli olgularda tüberkülin deri testinin değerlendirilmesi

Tüberküloz (tüberküloz) taramasında kullanılan tüberkülin deri testinin (TDT) hemodiyaliz (HD) uygulanan kronik böbrek yetmezlik (KBY)'li olgularda genel topluma göre yüksek oranda negatif bulunması, bu testin güvenirliliğini gölgelemektedir. Bu çalışmanın amacı; HD'e giren KBY'li olgularda, tüberküloz enfeksiyonu taranırken, TDT'nin değerlendirilmesi ve aynı zamanda BCG aşısı, HD süresi, hepatit markerleri ile TDT arasında korelasyon olup olmadığına bakılması idi. KBY'li 82 HD hastasına TDT yapıldı. Aynı zamanda BCG aşısı, HD süresi, hepatit markerlerine bakıldı. TDT olguların 38 (%46.3)'inde pozitif, 44 (%53.7) ise negatif olup, TDT'nin yalancı negatiflik oranı %53. 7 olarak bulundu. BCG aşısı, hepatit taşıyıcılığı ve HD süreleri ile TDT arasında bir korelasyon tespit edilmedi KBY'li olgularda hücresel immünitedeki azalma nedeni anerjinin sık görülür. Bu nedenle TDT'nin yararı diğer çalışmalarda olduğu gibi bu çalışmada da tüberküloz infeksiyonu tanısında yetersiz olduğu düşünülmektedir.

Evaluating tuberculin skin test in chronic renal failure patients undergoing hemodialysis

Negative results of tuberculin skin test (TST) which used searching for tuberculosis in patients who require hemodialysis (HD) treatment because of chronic renal failure (CRT) make suspects about its safe. Aim of this study was evaluating TST and researching correlation between this test and BCQ vaccination, HD period, hepatitis markers if there is any. TST were 82 HD patients CRF. At the same time, hepatitis markers were studied and HD period, BCG vaccination status were noted. TST is positive in 38 (%46.3) and negativite in 44 (%53.7). False negative ratio was %53.7. There was no corelation between BCG vaccination, hepatitis carrier, HD period TST. Anergia is common in patients with CRF, because of reduced cellular immunity. Because of, if it was thought that diagnostic value of TST is inadequate in diagnosis of tuberculosis in CRF patients which represent decreased cellular immunity and are frequently anergic. Conclusions: TST is insufficient in detecting tüberküloz infection which this is similar to other studies and also there is no correlation found between TST and BCG vaccination, hepatitis carriers and HD periods.

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