[Neutrophilic and lymphocytic factors of an immune response in renal tuberculosis]. / Neitrofil'nye i limfotsitarnye faktory immunnogo otveta pri nefrotuberkuleze.

Fifty-eight patients with nephrotuberculosis at its peak were found to have a high functional activity of neutrophilic granulocytes, as determined by the lysosomal cation test, by the levels of myeloperoxidase and lactoferrin. The subpopulation of lymphocytes, concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2), as well as those of IL-2 in a combination with its soluble receptor (SR-2) in the serum and supernatant of cellular cultures stimulated by phytohemagglutitin and PPD were studied. The findings suggest that there is a close correlation between the high concentrations of IL-2 and PP-alpha and the decreased content of activated lymphocytes expressing receptors to IL-2 (CD25+). Clinical remission has been ascertained to be attended only by a partial normalization of immunological parameters with antituberculous therapy.

[Determination of renotropic activity in the sera of 35 uninephrectomy patients].

The renotropic growth factor (RGF) does increase in postuninephrectomy serum although the majority of studies were conducted in experiment. As regard to whether there is postnephrectomy RGF in human being, we have not hitherto reached a conclusion. By incorporating tritiated thymidine (3H-TdR) into primary human kidney cells in culture. We have determined renotropic activity in the sera of 35 uninephrectomy patients. The RGF was found increased in 68% and 76% patients at postnephrectomy days 2 and 5 respectively, showing an average increase of 14% and 33% as compared with that of preoperation level. i.e. The RGF does exist in the sera of uninephrectomy patients. Through multifactorial analysis, it revealed that renotropic activity was higher in male and uninephrectomy patient with better renal function. The same was also found in the patient who had not encountered side effect derived from blood transfusion and that the kidney lesion was benign in nature. Female or senile patient with deteriorated renal function or those with malignant lesion or transfusion side effect showed a lower renotropic activity. But no significant statistic difference was seen between the two categories.

Renal tuberculosis and hypertension: value of the renal vein renin ratio.

We applied the central renal vein renin ratios in a group of patients with unilateral renal tuberculosis and hypertension to see whether the diseased kidney was involved in the pathogenesis of the elevated blood pressure. Of 20 patients 11 were nephrectomized, 7 had positive renal vein renin ratios and normal peripheral plasma renin activity; only 2 kept their blood pressure in control without medication. From 5 without a positive index, only 1 kept his blood pressure in control without medicine 1 year after surgery. The renal vein renin ratio has to be interpreted in light of other parameters, such as blood pressure, peripheral renin--if high the more the chance of being significant--and global renal function. The renal vein renin ratio alone per se gives poor information on the pressor role of a unilateral tuberculous kidney.

Pathogenesis and treatment of hypertension in renal tuberculosis.

39 patients underwent partial or total unilateral nephrectomy for treatment of renal tuberculosis. Before surgery, blood pressure was increased in 12 cases (30%). 5 patients had only mild hypertension which was not modified following surgery. 7 patients had moderate to severe hypertension, and in 5 of them blood pressure was normalized following nephrectomy, indicating a renal pressure mechanism. Special investigations in some of these patients revealed no evidence of a pathogenic role of the adrenergic system, but support the participation of the renin-angiotensin system in at least some patients with hypertension associated with renal tuberculosis.

Renal function damage in 131 cases of urogenital tuberculosis.

The functional sequelae of 131 patients with urogenital tuberculosis were examined. At the time of diagnosis, more than half of the patients already suffered from global renal failure which was moderate in 42.7 per cent and severe in 15.5 per cent. We believe that the primary functional damage occurs at the medullary level with tubular and interstitial involvement. Indeed, the red phenol test for postglomerular blood flow was altered in a higher proportion than was the creatinine clearance (67.9 per cent). The maximum concentrating ability was altered even more frequently (84 per cent). When we compared various glomerular filtration levels with the grade of alteration of the maximum ability concentration test, we also saw clearly that the alteration of the tubular interstitial medullar function dominated the alteration of the glomerular global function. This proves at a functional level the predominantly medullary localization of the lesion in renal tuberculosis.

[Significance of the tuberculin test in the early detection of renal tuberculosis]. / La portée du test à la tuberculine dans le dépistage de la tuberculose du rein

Authors used the tuberculin test (modified Koch's test) in 84 urological patients. In 22 of them, renal tuberculosis was revealed by this test and then confirmed by other methods. Subcutaneous injection of tuberculin in patients with renal tuberculosis was followed with the increase of leucocyturia and erythrocyturia. This reaction was especially expressive in the early stages of renal tuberculosis. The tuberculin test must be widely used in first-stage laboratory investigations in urological patients because it is easy and rapid.