Evaluation of Delayed-Type Hyper Sensitivity Skin Test In CKD Patients: Significance of Candin Test

Background: The high morbidity and mortality of patients with end stage renal disease have led to the development of a variety of guidelines for improving the care of patients on dialysis, and more recently the care of patients with early stages of chronic kidney disease. Methods & Findings: A prospective observational study was done on 240 nondiabetic chronic kidney disease patients and on 240 controls to assess the delayed hypersensitivity response by using Candin test. During Oct 2015 to July 2017 we enrolled 480 subjects and all were injected Candin antigen intradermally and evaluated for induration after 48 hours. Among these cases 35% patients showed positive induration while control group revealed 58.8% indurations. Induration was significantly more positive in stage 3 and 4 in comparison to stage 5. Cases with positive induration have higher eGFR value. Induration response was significantly more positive in the group which has not undergone for haemodialysis. Conclusion: The study concludes that by using Candin test we can single out in advance those patients who are in the state of deteriorating cellular immunity in order to provide additional therapy to improve quality of their lives and also vaccinate such patients with augmented regimens for providing extra protective cover for reducing the morbidity from various infections. During this study period no CKD patient of stage 1 and 2 has been enrolled but if the Candin skin test had been done on such patients, encouraging results would have been got by protecting them with several infections.