Tetanus antitoxin level in diabetic and nondiabetic hemodialysis patients

Hemodialysis patients are under risk for various infections because ofimpairment in their immune system. When considering the relationship of tetanus withacute injury, tetanus immunization is important in these group because of high densityof invasive processes, and frequent occurrence of small injuries because of neuropathyand vasculopathy especially in diabetic patients. In our country, there is no adequatestudy to show tetanus immunity in these patients and also no immunization program forthese patients.In this study, tetanus antitoxin levels were detected by ELISA method in diabeticand non-diabetic hemodialysis patients, diabetic non-hemodialysis patients and healthygroup. 452 patients were included in the study and age range was between 14 and 88years old. Tetanus antitoxin levels were found up to protective levels in 44.2% of thepatients, but there was no difference between patient groups. Entire protective antibodylevels were significantly lower in diabetic patients. Protective antibody levels weredecreased reverse to increasing age independent from underlying disease. The antibodylevels were higher in male patients and in patients who had prior vaccination. To servein military service among male patients were unrelated to antibody levels.An important proportion of the groups in the study were not immunized againsttetanus. Therefore, susceptible patients should be vaccinated. Constitution ofvaccination programs for patients with diabetes, chronic renal failure and also for elderhealthy persons is convenient.