Urogenital disorders

I./2.4.: Tuberculosis of the kidney (renal tuberculosis) Mycobacteriumtuberculosis]

Renal tuberculosis is the result of a discrete haematogenous dissemination. Usually it appears unilaterally. First cortical foci develop in the size of a millet, which then spread onto the medulla and finally reach the renal calices. Caseated pyramids necrotize (papillary necrosis), and the pyelon and the parenchyma are replaced with a cavern filled with dense, yellow-white necrotic substance (caseating cavernous renal tuberculosis). The tuberculosis spreads from the pyelon to the ureter and urinary bladder by canalicular spread. The ureter process scars and it closes the lumen. The exudate in the pyelon thickens and a mortar kidney develops . The ureter, sometimes even together with the whole kidney calcifies in a secondary process (autonephrectomy). Nowadays the development of the above mentioned process practically never occurs. Kidney impairment develops years after the dissemination.