Unusual presentation of tuberculosis in chronic hemodialysis patients

Clin Nephrol. 1977 Aug;8(2):363-6.


Four patients developed miliary tuberculosis while undergoing chronic hemodialysis. Two patients had diabetes mellitus. Three of the four patients were hemodialyzed 18--24 months prior to the onset of symptoms. Signs and symptoms included prolonged fever, pleural effusion, pericarditis with pericardial effusion, abdominal pain, weight loss, and ascites. All patients were PPD negative and without historical or radiographic evidence of latent tuberculosis. Disseminated tuberculosis was proven at autopsy in three patients. M. tuberculosis was eventually recovered from pleural fluid and urine in the fourth patient. The immune deficiencies of chronic renal failure and diabetes mellitus are suspected predisposing factors to the development of miliary tuberculosis in these patients.

Publication types

  • Case Reports

MeSH terms

  • Diabetic Nephropathies / complications
  • Diagnostic Errors
  • Ethambutol / administration & dosage
  • Female
  • Humans
  • Isoniazid / administration & dosage
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Pyelonephritis / complications
  • Renal Dialysis*
  • Tuberculosis, Miliary / diagnosis*
  • Tuberculosis, Miliary / drug therapy


  • Ethambutol
  • Isoniazid