A Study on the Protection of Hemodialysis Patients Against Diphtheria and Tetanus

Patients with end stage renal disease suffer from a high incidence of infectious diseases believed to be related to their impaired immune system. To determine the antitetanus and anti-diphtheria IgG antibody levels in Iranian hemodialysis patients with end stage renal disease, as well as its association with sex, age, hemoglobin, zinc serum level, serum albumin, duration of dialysis, number of dialysis per week, dialysis adequacy, erythropoietin or iron supplements such as venofer, body mass index (BMI), and underlying renal disorder, we conducted a cross-sectional study on a total of 112 hemodialysis patients with end stage renal disorder (60 male, 52 female) and 36 healthy individuals in the control group (14 male, 22 female). The patients and the control group received no antitetanus or antidiphtheria vaccine or immunoglobulin in the year prior to the investigation. The serum antitetanus and antidiphtheria IgG antibody levels were measured using the ELISA method. We found out that only 16% of our hemodialysis patients were immune to diphtheria (19% of the control group), and this rate for tetanus was 24% (48.2% in the healthy control). Except for the hemodialysis duration, none of the mentioned factors seemed to affect immunity. We conclude that in our study, the level of the antitetanus IgG antibody (unlike the antidiphtheria IgG antibody level) is significantly different among the hemodialysis patients, the chronic hemodialysis patients, and the control group.