Tuberculosis frequently afflicts patients suffering from chronic renal insufficiency or being treated with renal replacement therapy. Clinical symptoms may be vague and non characteristic, and the disease may primarily occur at extra-pulmonary sites. The overall prognosis may be poor, if the diagnosis is established with delay. The clinical cases discussed here are to illustrate that tuberculosis should be considered in any renal patient, who presents with unspecific symptoms and whose clinical condition deteriorates despite adequate dialysis treatment.