The Treatment of Renal Tuberculosis

Despite the introduction of potent anti-tubercutosis drugs, no decline in the incidence of genito-urinary tuberculosis had been noted in New Zealand over the last 15 years. Of all M. tuberculosis isolated at the Auckland Hospital Laboratory, 10% were resistant to one or more of the three commonly used drugs. Chemotherapeutic regimens, which may employ only oral medications, form the mainstay of successful treatment, and the possible benefits from surgical intervention are now limited to patients with advanced disease. Conservative surgery may prevent further renal parenchymal destruction and permit more effective sterilization of tuberculous foci. Nephrectomy may be undertaken with little risk and is still permissible in the presence of complete renal destruction, though there is a school of responsible thought that advocates the conservative treatment of all patients with renal tuberculosis.