Abstract
To determine changes in cell-mediated immunity in patients undergoing chronic hemodialysis, we performed phytohemagglutinin (PHA) skin tests and purified protein derivative (PPD) skin tests over a period of 10 years on 60 hemodialysis patients.
PHA skin test values were very low at the beginning of hemodialysis compared with the control groups. Though they returned to normal values within one year they decreased again by the third year of hemodialysis and become lower by the sixth year than at the beginning of hemodialysis.
The hemodialysis patients showed an early positive rate of 46.2% on the PPD skin test, increasing to 62.5% a year later. In general, cell-mediated immunity was found to have decreased in almost all patients regardless of the duration of hemodialysis. This lowered immunity is the most likely reason we were unable to protect them form tuberculous infection or malignant disease.
The PHA skin test values of eight patients who died had declined to extremely low values two years priod to their deaths. This may be characterized as a prognostic parameter.
