Tuberculosis of the kidney: symptoms and treatment
Jun 20, 2018
Tuberculosis of the kidneys is an infectious disease characterized by damage to the tissue structure of the organ, that is, its panichthmia.The causative agent of the disease is a stick of Koch( microbacterium tuberculosis).Infectious agent spreads with blood flow.First, only one kidney is affected, the second kidney can be in a healthy state for more than one year.
This ailment is found mainly in adults, and the male and female representatives fall ill with about the same frequency.In childhood, pathology is diagnosed very rarely.Contents: Why does kidney tuberculosis occur? Forms and stages The main symptoms of kidney tuberculosis Diagnosis of the disease Treatment of kidney tuberculosis
Why kidney tuberculosis occurs
Important ! The incubation period of kidney tuberculosis is quite long.Often the first symptom of pathology begins to appear only after two to three years after infection.The disease is very complex and dangerous, therefore requires timely and competent treatment.
As noted above, the main cause of the development of the disease is infection with the microbacteria of tuberculosis.The causative agent can enter the kidneys from both the internal infectious focus and from the external environment.Often, kidney tuberculosis develops on the background of untreated tuberculosis lesions in time.Also, infection by airborne droplets from another sick person is possible.
Renal damage occurs due to reduced specific immunity.In such situations, the kidneys simply can not cope with the infectious agent.
In addition, there are a number of factors that can provoke the disease:
- frequent colds;
- general or local hypothermia of the body;
- inaccuracies in nutrition, nutritional deficiencies, compliance with strict diets or fasting;
- traumatic injuries of the kidneys or other organs located near( ureters, adrenals, intestines, etc.);
- pathology of the urinary system;
- disorders of the endocrine system;
- professional activity in harmful production.
Forms and stages
It is customary to select acute miliary and chronic tuberculosis of the kidneys according to the clinical course.In the second case, the development of the disease occurs due to infection from the already existing in the body of the focus of tuberculosis - from the lungs.
In its development, the disease passes through several successive stages:
- infiltrative stage is characterized by the absence of destructive changes on the part of the kidney tissue;
- at the stage of initial destruction, already observed inflammation of the papillae of the organ( tuberculous papillitis), their gradual dying off, the formation of caverns( a tubercular cavity containing dry masses from dead cells);
- the stage of limited destruction is characterized by the presence of a large cavern or several such cavities in one kidney( polycavernous tuberculosis);
- at the started subtotal stage there is a total destruction of the affected organ: polycavernous tuberculosis of all renal segments.In fact, the organ is completely destroyed, and in its place a system of cavities is formed, which are separated from each other by septa from the connective tissue.In some cases, there is a very large cavern, the wall of which is the remainder of the preserved tissue of the kidney.
The main symptoms of kidney tuberculosis
Symptoms of kidney tuberculosis can easily be confused with manifestations of other diseases of the body, therefore it is very important to consult a doctor at the first pathological signs.
Among the main clinical manifestations of the ailment in question is:
- Hematuria - the presence of blood in the urine.Often, this symptom is accompanied by other impairments of urination, for example, frequent urge to empty the bladder at night and daytime, delay urination, pain in the process of urination.In some patients in the late stages of the disease, in addition to the admixture of blood in the urine, pus is also found;
- slight increase in body temperature( up to 37.5 degrees);
- weight loss with normal appetite and diet;
- persistent pain sensations of a dull character in the region of the waist and coccyx, renal colic;
- weakness, fatigue, reduced performance;
- increased blood pressure to values of 140/90 or more;
- general unsatisfactory state of health.
Important ! The absence of specific symptoms of kidney tuberculosis greatly complicates the timely diagnosis of pathology.Manifestations of the disease always depend on its stage and the prevalence of destructive processes, as well as from earlier therapy.
If you do not seek medical help in a timely manner, kidney tuberculosis can lead to serious and life-threatening complications.One of them is pionephrosis, which occurs in the last fourth stage of the disease.In this state, the organ is completely destroyed and becomes incapable of fulfilling the functions assigned to it.
A complete kidney atrophy can also result in a pathological process.In this case, the renal tissue is replaced by a connective tissue that does not respond to any function.In the diseased organ, it is possible to form deposits of calcium salts or amyloid( insoluble protein).
In case of irreversible disturbance of the functioning of the diseased paired organ, renal failure in chronic form develops.Pathology is caused by death of kidney cells and can lead to death.
Diagnosis of the disease
The diagnosis and treatment of kidney tuberculosis is handled by a nephrologist.
A number of highly informative research methods are used to assess the condition and function of the organ and to accurately diagnose the disease:
- Laboratory diagnosis of the ailment in question includes clinical general urine and blood tests, urine culture, seed culture, and PCR analysisFor the precise establishment of the causative agent of the infectious process;
- provoking tuberculin diagnostics - introduction of tuberculin with subsequent urine analysis;
- external examination and palpation of the area of the location of the kidneys - when the palpation increases, the patient experiences painful sensations when the palm is slightly tapping;
- magnetic resonance and computed tomography of the kidneys - modern diagnostic techniques that allow to determine the stage of the disease and the exact location of pathological foci;
- Angiography - X-ray examination of vessels with contrast;
- intravenous urography - X-ray examination with contrast of kidneys and urinary system;
- Neuroscintigraphy is the introduction of a small dose of radioactive material into the body to assess the function of the kidneys through a special gamma camera transmitting the image of the organ.
When an accurate diagnosis is made, the doctor will prescribe a comprehensive treatment that, depending on the stage of the pathological process, can include both conservative and operational techniques.
Treatment of kidney tuberculosis
This serious illness requires long-term treatment, which in no case can not be interrupted prematurely even with the onset of improvements.The average duration of the course of conservative therapy is one year.In this case, the patient is assigned various medications: anti-tuberculosis drugs, angioprotectors, anti-inflammatory drugs, antibiotics, immunomodulators.
To improve the effectiveness of drug treatment and accelerate recovery, individually selected physiotherapy procedures will help.Patients with renal tuberculosis often receive ultrasound, inductometry and other methods that promote the acceleration of regeneration of the affected tissues of the organ.
In addition, patients will need to strictly adhere to a special diet.The diet should include a large amount of animal protein and beneficial microelements.
If necessary, surgical treatment can be used organ-preserving surgery, such as kidney resection, which involves removing only that part of the organ that is affected by tuberculosis.Also, a cavernectomy is performed - excision of the cavity.
In severe cases, nephroureterectomy is indicated, involving removal of the kidney along with the ureter.After surgical treatment, patients are shown prolonged medication maintenance therapy( at least five years).Sanatorium treatment in places with a dry, sunny climate will help patients recover better after a serious illness.
Tuberculosis of the kidneys is a serious and complex pathology requiring long-term, urgent treatment.In order to avoid the development of dangerous complications, you should carefully consider your health and do not ignore anxious symptoms.
Chumachenko Olga, medical reviewer