Fever: thermal regulation and alterations in end stage renal disease patients.

This article presents an overview of thermoregulatory mechanisms, the pathophysiology of fever, and alterations of the febrile response in end stage renal disease (ESRD) patients. Many ESRD patients do not exhibit the expected rise in white blood cell count or body temperature during clinical and laboratory-confirmed infections. Therefore, leukocytosis and fever cannot be relied on for the diagnosis of bacterial infection in ESRD patients.