Renal tuberculosis (renal TB) or tuberculosis of the kidney is a type of extra-pulmonary tuberculosis that affects the kidney. Extra-pulmonary tuberculosis refers to tuberculosis that affects an organ outside the lungs. Other sites of extra-pulmonary tuberculosis are the pleura (the covering of the lungs), the lymph nodes, the fallopian tube in females and the epididymis in males, the bone marrow, and the hindbrain.
Renal tuberculosis may affect either one or both kidneys. The inner part of the kidney called the medulla is usually affected, though the infection usually starts from the cortex which is the outer part. Renal tuberculosis is sometimes a part of the tuberculosis that affects the entire genitourinary tract.
Renal or kidney tuberculosis is caused by Mycobacterium tuberculosis and is one of the most common forms of TB. It usually develops in adults, but it is also possible to have kidney TB in children.
Kidney TB is more likely to develop in those with pulmonary tuberculosis. This is because lung TB can spread to the kidneys by lymphatic or hematogenous means. Moreover, if the bacilli have been displaced from the lung by anti-TB drugs, they can spread to the kidneys through the bloodstream.
There are no early symptoms of kidney tuberculosis, and most people have no signs or symptoms until they have been diagnosed. The clinical symptoms of urogenital TB are insidious and can be difficult to diagnose and treat. Symptoms can include:
These symptoms can also be associated with a genital mass or pelvic tenderness, obstructive urination, and abdominal colic. In addition, patients may develop interstitial nephritis and acid-fast bacilli, which tests can identify.
Renal tuberculosis is difficult to diagnose since not too many physicians will suspect the condition. However, it is important to diagnose it since the patient can recover completely with the right treatment.
Tests used to diagnose renal tuberculosis include the following:
Blood tests that should be done include the following:
Tuberculin skin test
The following urine tests may be done to diagnose renal tuberculosis:
Imaging tests of the urinary system that may be used in the diagnosis of renal tuberculosis include the following:
Note: Rate any residual disability of infection within the appropriate body system as indicated by the notes in the evaluation criteria. As applicable, consider the long-term health effects potentially associated with infectious diseases as listed in §3.317(d) of this chapter, specifically Brucellosis, Campylobacter jejuni, Coxiella burnetii (Q fever), Malaria, Mycobacterium Tuberculosis, Nontyphoid Salmonella, Shigella, Visceral Leishmaniasis, and West Nile virus.
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