Clinical study
Tuberculosis in patients undergoing maintenance hemodialysis

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Abstract

Tuberculosis was diagnosed in eight patients undergoing maintenance hemodialysis and occurred with an incidence 10 times that of the general population. Dialysis-associated tuberculosis is characterized by intermittent fever, anorexia, weight loss and hepatomegaly. Ascites was present in 50 per cent of the patients. A recently converted positive tuberculin skin test was observed in five of eight patients.

Tuberculosis was extrapulmonary in seven of eight cases and consequently the diagnosis was frequently delayed. Over-all mortality was 37.5 per cent and correlated with the duration of symptoms prior to initiation of therapy.

A trial of antituberculous therapy is warranted in patients undergoing dialysis in whom fever of unknown origin, anorexia, weight loss and/or hepatomegaly develop particularly in areas endemic for tuberculosis.

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    From the Department of Medicine, Brooklyn V. A. Medical Center and the Downstate Medical Center, Brooklyn, New York.

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