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| |  DG DISPATCH - IUATBLD: Unexplained Kidney Stones May Suggest Renal Tuberculosis By W. A. Thomasson Special to DG News
CHICAGO, IL -- March 4, 2001 -- Kidney stones without discernable etiology may suggest a diagnosis of renal tuberculosis, according to data presented here yesterday (March 3) at the 6th annual meeting of the North American region of the International Union Against Tuberculosis and Lung Disease. The data was presented in poster format by Jacobo Kelber, MD, and A. Paz, MD, of the Hospital Angeles de Las Lomas in Mexico City and of the San Francisco, California, Public Health Department. The study covered all kidney stone patients seen at the hospital during the period between 1997 2000 in whom a standard metabolic work-up did not establish an etiology. This left 12 patients in the study, compared with 22 for whom a metabolic etiology was established. Patients without a metabolic etiology were further examined by staining and culture of first-voided urine for acid-fast bacilli, by medium-strength PPD test, and by chest X-ray. Ten of the 12 patients were found to have renal tuberculosis on the basis of urine smear and culture for Mycobacterium tuberculosis. All, however, had normal chest X-rays. Mexico City is considered to have a moderate prevalence of tuberculosis - higher than in most of the United States, but comparable to that in many high-risk US populations. Thus, the finding by Drs. Kelber and Paz that renal tuberculosis is present in 83 percent of patients with kidney stones but no etiologic diagnosis on standard metabolic work-up may have application in the US as well. At least for patients in high-risk groups, and perhaps for all patients, renal tuberculosis should be considered as a possible cause of kidney stones when no other etiology can be readily identified, the researchers concluded.
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