Introduction to the treatment of renal tuberculosis

Renal tuberculosis is a systemic tuberculosis disease. Since it poses a great threat to human health and life, it must be treated with care, including the use of some anti-tuberculosis drugs and surgical treatment. Surgical treatment can be effective.

(I) Anti-tuberculosis drug treatment: The basic conditions for simple drug treatment are that the renal function is still good and there is no obstruction to urine drainage. The indications for drug treatment are: ① Preclinical renal tuberculosis; ② Renal tuberculosis with smaller lesions; ③ Bilateral or solitary renal tuberculosis in the late stage who are not suitable for surgery; ④ There are active tuberculosis in other parts of the body who are not suitable for surgery for the time being; ⑤ Patients who suffer from other serious diseases and are not suitable for surgery for the time being; ⑥ Cooperative surgical treatment.

(B) Surgical treatment: Surgical treatment of renal tuberculosis includes nephrectomy, partial nephrectomy and renal lesion removal. The choice of surgical approach depends on the extent and severity of the disease and its response to medical therapy.

1. Nephrectomy: Unilateral renal tuberculosis with a large destruction area, unilateral tuberculous pyonephrosis, calcified kidney, and if the contralateral kidney has good function, are all suitable for nephrectomy. In the case of bilateral renal tuberculosis, when one side is severely damaged and renal function is impaired while the lesions on the other side are milder and sufficient to compensate, the severely affected kidney should be removed with the use of anti-tuberculosis drugs.

2. Partial nephrectomy: Partial nephrectomy is suitable for lesions confined to one pole of the kidney that have not improved after long-term drug treatment, or for patients with calyceal infundibulum stenosis that leads to poor urine drainage.

3. For tuberculous cavities formed near the surface of the renal parenchyma that are not connected to the renal calyx and are not responsive to drug treatment, renal lesion removal surgery can be performed.