Analysis of the clinical characteristics of 765 renal tuberculosis patients: based on 10 years of experience in four provincial teaching hospitals

OBJECTIVE: To explore the clinical characteristics of the current diagnostic and therapeutic approaches for renal tuberculosis. METHODS: Clinical diagnosis and treatment data from 765 patients definitively diagnosed with renal tuberculosis between January 2013 and December 2022 were retrospectively analyzed to identify optimal diagnostic and treatment modalities guiding clinical practice. RESULTS: The number of patients with clinically atypical renal tuberculosis has fluctuated in the last decade, but the changes are not statistically different. T-SPOT, CT, and endoscopy are still commonly used tests with high diagnostic value in clinical practice. The efficacy of anti-tuberculosis drugs was suboptimal, resulting in a cure rate of only 15.43% and a progression rate of only 68.55%. Ureteral stent placement, although effective in relieving hydronephrosis, does not reverse renal impairment and has a 21.43% cure rate and a 57.14% progression rate. Surgical resection was necessary for the majority of patients, with a nephrectomy rate of 76.34% and a cure rate of 81.12%. CONCLUSION: The prognosis for renal tuberculosis is generally poor, particularly in cases of bilateral involvement. Accurate diagnosis and surgical resection of the tuberculous kidney are essential for preventing complications associated with advanced renal tuberculosis.