Epidemiology Clinical Symptoms And Digenesis Features Of Atypical Renal Tuberculosis

Objective:To investigate the difference of the incidence and clinical characteristics between typical and atypical renal tuberculosis, and investigate the method of diagnosis, improve the level of diagnosis of renal tuberculosis. Methods:In the study, 128 cases of renal tuberculosis from 2009 to 2014 were retrospectively reviewed. Typical group(56cases) and atypical group(72cases). Epidemiological characteristics, the incidence and previous cases of tuberculosis, clinical features, complications of advanced renal tuberculosis, laboratory results, imaging results were analyzed retrospectively.Results:1. The cases of renal tuberculosis incidence rates were higher in the 40-60 years old patients. 48% of the patients were farmers or the unemployed. Atypical renal tuberculosis 72 cases, typical renal tuberculosis 56 cases. 28 renal tuberculosis cases were diagnosed at first time, 62 cases previous or existing at the same time of pulmonary tuberculosis(48.44%)2. The most common clinical manifestation included frequency(82 cases), urgency(51 cases), odynuria(50cases), flank pain(54cases), and hematuria(23cases). The most common clinical manifestation of typical renal tuberculosis are frequency(56 cases), urgency(48 cases), odynuria(42cases), However, flank pain(28cases)turned into the main complaint of the atypical group. We found that 62 cases had a history of pulmonary tuberculosis or an abnormal chest radiography result. Ureter(39 cases) as the main merger affected area. 8 patients were diagnosed as contracted bladder(typical group/atypical group:7/1,P<0.05), 11 patients were diagnosed as contralateral hydronephrosis, Unilateral severe renal impairment has 84 cases, 5 cases patients were diagnosed as abnormal serum creatinine.3. There were 123 cases of abnormal urine routine examination. 126 cases were examined by acid-fast stain, with a positive diagnostic rate of 47.62%. 128 patients who had an ultrasonography had an abnormal outcome and 23 cases of them were definitively diagnosed. 128 patients who had an IVU had an abnormal outcome and 42 cases of them were definitively diagnosed. And 128 patients who had an CT had an abnormal outcome and 102 cases of them were definitively diagnosed(79.69%)(typical group/atypical group:48/54, P>0.05). Conclusion:Renal tuberculosis incidence rates were higher in the 40-60 years old patients. Socio-economic issues still affect the status of genitourinary tuberculosis. Atypical renal tuberculosis cases increased. The main clinical symptoms of typical renal tuberculosis is bladder irritation, flank pain turned into the main complaint of the atypical group; The history of pulmonary tuberculosis and an abnormal outcome of chest radiography can provide an important clue during the diagnostic process. The proportion of One side renal tuberculosis with the opposite side renal hydronephrosis is decreased. Urine routine test, acid-fast stain, ultrasonography have great value for screening of renal tuberculosis. IVU are basic tests for the examination of renal tuberculosis. CT can be used as the main means of renal tuberculosis examination.