Prevalence of latent tuberculosis and associated factors in patients with chronic kidney disease on hemodialysis.
Viviane Ferreira, Cassiane Dezoti da Fonseca, Valdes Roberto Bollela and 4 others
PMID 34287541WHAT IT FOUND
In hemodialysis patients, 8.5% tested positive for latent tuberculosis.
Having regular garbage collection or diabetes was linked to a lower chance of a positive skin test. A negative test does not rule out infection in this high-risk group.
Key findings
01The prevalence of latent tuberculosis (positive tuberculin skin test) in the study sample was 8.5%.
02Patients with diabetes were less likely to have a positive test result compared to those without diabetes.
03Having regular garbage collection was associated with a lower likelihood of a positive test result.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot establish cause and effect or the timing of exposures. It was conducted at only two units in one Brazilian city, limiting generalizability to other populations. The tuberculin skin test can yield false negatives in immunocompromised patients, which may explain the unexpected 'protective' association with diabetes. Data on exposure and outcome were collected simultaneously.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the association between diabetes and a lower chance of a positive skin test as evidence that diabetes protects against tuberculosis. The authors attribute this finding to immune suppression causing false-negative test results, meaning these patients are still at risk for infection.