Korean J Nephrol.  2001 Jul;20(4):695-701.

A Clinical Study on Early Nephrectomy with Short-term Antituberculous Chemotherapy for Nonfunctioning Tuberculous Kidney

• You HS
• Yoon SM

Abstract

PURPOSE: A clinical review was performed to evaluate the importance and effectiveness of early nephrectomy & the result of short-term chemotherapy on unilateral, nonfunctioning tuberculous kidneys.
METHODS
Retrospective study was made on 34 patients with nonfunctioning tuberculous kidneys who underwent nephrectomy from February 1986 to December 1998. All patients were evaluated by annual frequency, age, sex and site distribution, presenting symptoms, tuberculous lesion on organs other than kidney, cystoscopic finding, urinalysis and urine AFB smear & culture, urine Tb-PCR, CBC & ESR finding, perioperative morbidity and mortality, treatment distribution(Group 1 and 2) and drug toxicity.
RESULTS
In pathologic findings of the 39 cases in which nonfunctioning tuberculous kidneys were suspected, 5 cases had no evidence of tuberculosis. Those were xanthogranulomatous pyelonephritis(2 cases), chronic pyelonephritis with hydronephrosis(2 cases) and complicated multilocular cyst(1 case). Coexisting renal cell carcinoma was found in 1 case. 4 cases(11.7%) were hypertensive at the time of presentation and 3 cases of them had a decrease in blood pressure after nephrectomy. 7 cases(20.5%) had febrile symptom, 5 cases of them had renal & perirenal abscess(4 cases) and cutaneous fistula(1 case). No perioperative mortality occurred and perioperative complications(sinus arrhythmia, wound infection, wound dehiscence, ileus) were in 5 cases(14.7 %). There was no evidence of recurrence during follow-up periods(Follow-up mean periods : 18.5 months).
CONCLUSION
Early nephrectomy is an effective treatment in the comprehensive management of the unilateral, nonfunctioning tuberculous kidneys, for accurate diagnosis, removal of infection focus, early control of presenting symptoms and prevention of tuberculosis recurrence. And this should be followed by postoperative, acceptable short-term antitubercul ous chemotherapy.

Keyword

Nonfunctioning tuberculous kidney; Nephrectomy; Antituberculous; Chemotherapy

MeSH Terms

Arrhythmias, Cardiac
Blood Pressure
Carcinoma, Renal Cell
Diagnosis
Drug Therapy*
Drug-Related Side Effects and Adverse Reactions
Follow-Up Studies
Humans
Kidney*
Mortality
Nephrectomy*
Pyelonephritis
Recurrence
Retrospective Studies
Tuberculosis
Urinalysis
Wound Infection
Wounds and Injuries