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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Introduction of specific chemotherapy and vaccination leads to a remarkable recession of renal tuberculosis in the younger age group. Renal tuberculosis is the result of a haematogenous spread of tubercle bacillus. Haematogenous spreading occurs immediately after primary infection, or, in elderly patients, in combination with recurrency of tuberculous foci in lungs and hilar-lymphnodes. Simultaneous metastasis in the skeleton, especially in the vertebrae, are observed in 30%. The incubation period between tuberculous spread and clinical manifestation of renal tuberculosis lasts several years, in the average 5-8 years, for calcareous kidneys it may last as long as 20 years and more, for tuberculous pyelitis only a few months. Today it is possible to treat renal tuberculosis with drugs (Streptomycin, PAS and INH). In 13% the cicatrisation is combined with obstruction of calices and partial hydronephrosis, in 7% with obstruction of the ureter and total hydronephrosis. Early chemotherapy may prevent the development of tuberculous hydronephrosis.
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PMID:[Pathology of renal tuberculosis (author's transl)]. 95 6

Nephrectomy is a radical operation successfully used over more than a century. It should be resorted to only in exceptional situations whenever an organ salvaging operation is precarious for the patient's health (T Patrashkov, 1980). The indications for nephrectomy depend on the type of disease, extent of renal damage, state of the second kidney and the patient's general condition, established by the basic examination methods in urology (T Patrashkov 1982). The study covers 388 nephrectomies in cases presenting diverse diseases of the kidney and ureter, diagnosed and treated in the Department of Urology--University Hospital "Alexandrovska" in the period 1990 to 1995. The commonest causes leading to nephrectomy comprise: 1. Neoplasms of kidney and ureter--134 (34.54%). 1.1. Parenchymal tumors--116 (29.90%)/ 1.2. Papillary tumors--18 (4.64%). 2. Pyonephrosis--88 (22.68%). 3. Nephrolithiasis (presence of renal calculi)--53 (13.66%). 4. Secondary operations of the kidney and ureter--46 (11.86%). 5. Hydronephrosis--38 (9.80%). 6. Anomalies (hypoplasia)--8 (2.06%). 7. Cystic diseases--7 (1.80%). 8. Tuberculosis of kidney--6 (1.55%). 9. Renovasal hypertension--4 (1.02%). 10. Nephrectomy for other diseases--4 (1.02%). As shown by the results the rate of nephrectomy undertaken for renal malignancy is still the highest which is by no means considered as a favourable diagnostic sign.
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PMID:[Kidney diseases most often considered as indications for nephrectomy]. 1148 42

Renal TB is difficult to diagnose, because many patients present themselves with lower urinary symptoms which are typical of bacterial cystitis. We report a case of a young woman with renal TB and ESRD. She was admitted with complaints of adynamia, anorexia, fever, weight loss, dysuria and generalized edema for 10 months. At physical examination she was febrile (39 degrees C), and her abdomen had increased volume and was painful at palpation. Laboratorial tests showed serum urea = 220 mg/dL, creatinine = 6.6 mg/dL, hemoglobin = 7.9 g/dL, hematocrit = 24.3%, leukocytes = 33,600/mm(3) and platelets = 664,000/mm(3). Urinalysis showed an acid urine (pH = 5.0), leukocyturia (2+/4+) and mild proteinuria (1+/4+). She was also oliguric (urinary volume < 400 mL/day). Abdominal echography showed thick and contracted bladder walls and heterogeneous liquid collection in the left pelvic region. Two laparotomies were performed, in which abscess in pelvic region was found. Anti-peritoneal tuberculosis treatment with rifampin, isoniazid and pyrazinamide was started. During the follow-up, the urine culture was found to be positive for M. tuberculosis. Six months later the patient had complaints of abdominal pain and dysuria. New laboratorial tests showed serum urea = 187 mg/dL, creatinine = 8.0 mg/dL, potassium = 6.5 mEq/L. Hemodialysis was then started. The CT scan showed signs of chronic nephropathy, dilated calyces and thinning of renal cortex in both kidneys and severe dilation of ureter. The patient developed neurologic symptoms, suggesting tuberculous meningoencephalitis, and died despite of support measures adopted. The patient had ESRD due to secondary uropathy to prolonged tuberculosis of urinary tract that was caused by delayed clinical and laboratorial diagnosis, and probably also due to inadequate antituberculous drugs administration.
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PMID:End-stage renal disease due to delayed diagnosis of renal tuberculosis: a fatal case report. 1762 50