Tuberculosis screening in a dialysis program.
Patients with end stage renal disease (ESRD) are at high risk for contracting tuberculosis (TB), therefore, routine screening of these patients is recommended This article describes the steps used to design and implement a TB screening protocol in a new regional dialysis program. The results showed a high rate of skin test positivity and, therefore, of infection. Over half of the patients tested were found to be anergic, necessitating a chest x-ray for 70% of the patients. In light of these findings, the annual skin testing of all patients, which was originally planned, has been changed to testing upon admission to the program, providing a baseline with which to compare subsequent skin tests.
Ballantine
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York Region Dialysis Program, York Central Hospital, Richmond Hill, Ontario.
D000465:Algorithms; D002985:Clinical Protocols; D016358:Contact Tracing; D003663:Decision Trees; D006301:Health Services Needs and Demand; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000276:immunology / Q000628:therapy; D008403:Mass Screening / Q000458:organization & administration*; D009864:Ontario / Q000453:epidemiology; D009937:Organizational Objectives; D018579:Patient Selection; D016730:Program Development; D015397:Program Evaluation; D006435:Renal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control