The Diagnosis And Treatment Of The Renal Tuberculosis

Objective: studying the clinical characteristics,the principl of diagnosis and treatment in the renal tuberculosis,to improve diagnosis and treatment in the renal tuberculosis.Methods : The clinical data of 70 cases of renal tuberculosis treated in our departments from 1999 to 2006 were reviewed and analyzed,which included the clinical characteristics,urine analysis,urography and treatment.Results : The age in 68.5 percent patients of the renal tuberculosis ranged from 21 to 50 years old.The most frequent clinicl symptoms was urinary frequency,odynuria and lumbodynia.The 48.6 percent of renal tuberculosis complicated with lung tuberculosis. The rate of atypical renal tuberculosis was 65.7%.The positive results of urine analysis is about 80%, acid-fast stains on urinary sediment 17%,urine PCR-TB-DNA 40%.The diagnos accordance rate of B-type ultrasonography,KUB+IVU,CT was 61.4%,35.5%,52.9%.40 patients underwent the nephrectomy,13 patients were cured by anti-tuberculosis agents.kidney stoma was performed firstly for those casees of double kidney tuberculosis or renal tuberculosis with contralateral hydronephrosis ,and drug treatment,nephrectomy or plastic operation would be performed on the basis of patients condition .one patient was hemodialysis due to uremia.except one patient with perinephritic abscess who was still treated,all of the cases procured follow-up visit were cured or their renal function was stable. Conclusions : The age in 68.5 percent patients of the renal tuberculosis ranged from 21 to 50 years old.The most of the cases complicated with lung tuberculosis.The rate of the atypical renal tuberculosis has increased obviosily.Its need to aggregate analysis the clinical characteristics,laboratory examination and imageology examinatiom for the diagnosis of early renal tuberculosis.Routine urianlysis is the basic method for the diagnosis of renal tuberculosis. Acid-fast stains on urinary sediment and urine PCR-TB-DNA is important for pathogen detection. B-type ultrasonography is the first choices for the renal tuberculosis,IVU can get the message of renal function,and CT scan is necessary to the renal anatomic structure before the surgical operation.The early renal tuberculosis can be cured by drug treatment,and nephrectomy is very important for the intermediate or advanced renal tuberculosis.