Abstract
Kidney tuberculosis (KTB) has non-specific clinical features and mimics on different other urological diseases: urolithiasis, cancer, pyelonephritis, cystitis etc. Moreover clinical features are not stable for ages, they change rather quickly.
The aim was to compare KTB in Siberia in 1980-1990 (1st group, 268 patients) and in 2000-2005 (2nd group, 227 patients), all were in-patients of Urogenital Department of Novosibirsk Research TB Institute.
A flank pain in 1st group was rarer (58.9% and 72.8% accordingly), but frequency of dysuria was the same (57.1% and 54.3%). Frequency of renal colic decreased from 16.1% up to 12.3%; haematuria increased from 30.4% up to 48.1%. Pyuria left most common laboratory sign – 91.7 – 91.4%. Significantly reduced a frequency of positive cultures – mycobacteriuria was revealed in 84.5% in first group and in 44.0% only in novo days.
Asymptomatic course was about equal – 8.9% and 6.2%, but frequency of acute debut changed significantly. In 1st group 34.5% patients got sick acutely, with manifesting clinical features, fever, pain etc. In second group the same patients there were 4.9% only. On contrary, obscure, vogue symptoms were in 56.6% in 1st group and in 88.9% - in 2nd group.
Mean age was stable: 40.5 in 1st group and 43.8 in 2nd group. A rate male: female was about 2:3 in both groups.
Conclusion: We can speak about clinical pathomorphosis of KTB. Clinical features of KTB has changed in last years. In 7 times rarer became acute onset of KTB, significantly more often patients have flank pain and haematuria now. Asymptomatic course of KTB is possible too. All this may be a reason for late diagnosis.
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