Clinical and Morphological Changes in non Obstructive Renal Tuberculosis

Renal histopathology in non-obstructive stage of urinary tuberculosis revealed seven types of lesion viz; a) nil lesion without nephrotic syndrome (35%); b) minimal change glomerulonephritis (15%); c) focal global sclerosis (5%); d) focal segmental proliferative glomerulonephritis (5%); e) chronic pyelonephritis (15%); f) amyloidosis (20%) and g) focal segmental glomerulosclerosis (5%).
Patients having nil lesion without nephrotic syndrome were young, presented with hematuria (57.14%) and positive IVP abnormalities (71.42%) with nil to mild proteinuria. Patients with sclerosing and proliferative lesions mainly presented with hematuria and 2/3 had IVP abnormalities. Amyloidosis patients had generalized swelling all over body with blood pressure towards lower side of normal, marked proteinuria and hypoalbuminemia, 50% of them had long standing pulmonary tuberculosis with normal IVP findings.