Answered by: Dr Ramzdhan
Doctor, I have a friend who has to be hospitalised due to TB and the doctors said he was fortunate that the disease did not affect his kidneys. Can TB affect the kidneys and what will the complications be?
Hi, thank you for your question.
Tuberculosis (TB) is a serious infectious disese that mainly affects the lungs. It is commonly caused by Mycobacterium tuberculosis (human origin), and less commonly Mycobacterium bovis (bovine origin). If TB lesions in the lungs erode the walls of blood vessels and gain access into the vascular system, it can spread to other parts of the body through the bloodstream. However, these microorganisms can only survive and grow in a few sites in the body, such as the kidneys, bone marrow, fallopian tube, epididymis and brain. When these microoganisms grow in the kidneys, patients can develop renal TB. Renal TB can occur during an active disease in the lungs or as another infection on its own after a period of dormancy.
Patients usually experience symptoms similar to those in a urinary tract infection. These symptoms include pain in flanks, stomach, back or groin, nausea and vomiting, fever, increased need to urinate, pain during urination and changes in urine colour. Some patients may also have night sweats and weight loss, but these rarely happen. If they develop persistent pyuria (pus in the urine) and hematuria (blood in the urine), they should have a thorough examination of their urinary system. Tests to help diagnose renal TB are urine culture, mantoux test (TB skin test), intravenous urography (IVU), computerised tomography (CT) scan, ultrasound, or tissue biopsy of the kidneys and urinary tract. In the early stage of renal TB, the kidneys may become calcified. In the later stages, there may be changes in the kidney structure, such as distortion of kidney chambers, ureteral stricture (obstruction of the tube that drains urine from kidneys to bladder), and bladder fibrosis (thickening and scarring of bladder wall). These changes can render the kidneys non-functional and may progress to end-stage renal failure.