Tuberculosis (TB) is a communicable disease that is a major cause of ill health and one of the leading causes of death worldwide. India is the highest TB burden country in the world having an estimated incidence of 26.9 lakhs in 2019. Patients with chronic kidney disease are more prone to develop active Tuberculosis owing to various factors. The predominant defect in such cases is immunodeficiency (1). Inflammation, oxidative stress, nutritional deficiencies including vitamin D deficiency play a role as well. To add to these immune cells like B cells, T cells, neutrophils, monocytes, and NK cells also have defective function thus resulting in inability to counter Myobacterium tuberculosis. Very often CKD patients also have coexistent conditions like Diabetes, HIV, renal transplant. Profound immunodeficiency can start in stage 3 CKD thereby worsening further in later stages (2). Active TB may be acquired after new exposure or reactivation from previous exposure. Diagnosis of TB in CKD patients is not easy as disease presentation is quite different from non-CKD patients owing to immunodeficiency. The treatment is equally challenging due to drug interactions and deranged pharmacokinetics (3,4). This study aimed to study the spectrum of Tuberculosis occurring in CKD patients attending our Hospital.