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Tuberculosis in Chronic Renal Failure

M. Anees Khan, MD; Bangaruswamy Chandrasekaran, MD; Mark Needle, MD
Arch Intern Med. 1981;141(11):1554. doi:10.1001/archinte.1981.00340120162037.
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To the Editor.  —In the Archives (1980;140:1674-1675), Brandspigel and Mattern have duly emphasized the risk of tuberculosis among patients with chronic renal failure (CRF), particularly those undergoing maintenance hemodialysis. Not only is the incidence of tuberculosis higher in this group of patients,1-4 but also extrapulmonary forms of tuberculosis are particularly frequent.In a group of 110 patients with CRF undergoing maintenance hemodialysis cared for at St Joseph's Hospital and Medical Center, Paterson, NJ, six had tuberculosis develop, four of whom had extrapulmonary tuberculosis (unpublished data). Diagnostic difficulties in this group include nonspecificity of symptoms, high incidence of other infectious illnesses, negative tuberculin skin reactions, as well as a lack of microorganisms in the involved organs.Although we concur with Brandspigel and Mattern and others in recognizing that the patients with CRF constitute a high-risk group for reactivation of latent tuberculous infection, we do not believe that this group requires


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