Tuberculosis in patients on hemodialysis

Six of 102 patients with end-stage renal disease (ESRD) who underwent hemodialysis treatment from 1972 to 1980 developed active tuberculosis (TB). Three of six patients were Yemenite Jews, an ethnic group constituting only 10.8% of the dialysis population; thus, Yemenite Jews appear to be especially at risk among Israeli dialysis patients. Fever of unknown origin was the most frequent presenting symptom. In four patients, previous TB of the lungs was documented. These data support the view of reactivation of dormant TB as the main pathogenetic pathway for the development of the active disease. Two patients died, whereas four recovered on triple therapy with isoniazid, rifampicin and ethambutol.