title: Acute effect of low-flux hemodialysis process on the results of the interferon-gamma-based QuantiFERON-TB Gold In-Tube test in end-stage renal disease patients.
abstract: BACKGROUND
  Screening for latent tuberculosis infection before solid organ transplantation is mandatory, but this is not so easy in uremic patients on hemodialysis (HD) treatment. The newly developed interferon-gamma (IFN-gamma)-based QuantiFERON((R))-TB Gold In-Tube test (QFT-G) seems to be superior to the other available tests. Objective. To investigate the acute effect of the low-flux HD process on the results of the QFT-G assay.
  
  
  METHODS
  A total of 56 HD patients participated in this prospective study. They were dialyzed under low-flux HD for at least 1 month before blood sampling for QFT-G assay. This assay was performed before and after the 4-h low-flux HD session.
  
  
  RESULTS
  Compared with the pre-dialysis level, there was an obvious reduction in the IFN-gamma production level (in response to the TB-antigen cocktails) after the HD process (P=0.00). The pre-dialysis test result was negative in 21 (37.5%), positive in 33 (58.9%), and indeterminate in 2 (3.6%) patients. One pre-dialysis negative result changed to positive after the HD process. On the other hand, 7 pre-dialysis positive and 2 indeterminate results become negative after HD (P=0.012).
  
  
  CONCLUSIONS
  In order to maintain the sensitivity of QFT-G assay in chronic renal failure patients on low-flux HD treatment, it is better to perform the test immediately before (not after) the HD process.
authors.affiliation: Internal Medicine Department, Vakif Gureba Training and Research Hospital, Fatih, Istanbul, Turkey. hursitoglum@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Hursitoglu
authors.forename: M A
authors.initials: MA
authors.lastname: Cikrikcioglu
authors.forename: T
authors.initials: T
authors.lastname: Tukek
authors.forename: I
authors.initials: I
authors.lastname: Beycan
authors.forename: N
authors.initials: N
authors.lastname: Ahmedova
authors.forename: S
authors.initials: S
authors.lastname: Karacuha
authors.forename: M
authors.initials: M
authors.lastname: Sansal
authors.forename: O
authors.initials: O
authors.lastname: Ozkan
authors.forename: V
authors.initials: V
authors.lastname: Celik
mesh_terms: D000328:Adult; D000942:Antigens, Bacterial / Q000276:immunology; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000276:immunology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D011933:Reagent Kits, Diagnostic; D006435:Renal Dialysis; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology
chemical_list: D000942:Antigens, Bacterial; D011933:Reagent Kits, Diagnostic; D007371:Interferon-gamma