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June 4, 1982


JAMA. 1982;247(21):2962-2965. doi:10.1001/jama.1982.03320460062024


Tuberculosis in Chronic Renal Failure.—  Topics in medicine have a mysterious way of appearing and disappearing. Tuberculosis, one of mankind's ancient sorrows, is a good example.We are now in the midst of a resurgence of interest in tuberculosis as seen in patients with chronic renal failure. Andrew and colleagues1 have presented some interesting data based on ten patients with active tuberculosis, taken from an adult dialysis population of 172 patients over a ten-year period. This is an incidence of tuberculosis 12 times that of the general community. Thus, as expected, tuberculosis behaves as an opportunistic pathogen seeking vulnerable hosts.The well-known anergy of uremia may play a role in the further observation that nearly half of the patients with active tuberculosis had negative PPD test results.1 The presenting symptoms tended to be constitutional rather than pulmonary and included fever, malaise, and weight loss more commonly than