[Capacities of rapid diagnostic methods in renal tuberculosis].

The paper comparatively assesses routine and new medical technologies (metachromatic urine test, polymerase chain reaction, chromatographic mass spectrometry, and enzyme immunoassay) for detection of Mycobacterium tuberculosis and tuberculosis antibodies. It is shown that molecular biological and immune assays may be used only for rapid diagnosis and screening, followed by a full-scale phthisiourological study as the detection of markers of Mycobacterium tuberculosis and tuberculosis antibodies cannot be a criterion for establishing renal tuberculosis. The authors consider that the conventional microbiological tests whose validity is beyond question in case of positive results are the most established and practice-tested canons of phthisiourological diagnosis.

[Treatment of renal tuberculosis].

Three groups of parameters of 4 tuberculostatics effects on tuberculosis of the kidneys and general condition were singled out basing on comparative efficacy of 3 and 4 mycobacterial drugs: more effective, equally effective and negative. Higher efficacy manifested with greater number of cases of leukocyturia elimination and conversion of cultivable mycobacteria into uncultivable ones, more obvious morphological signs of tuberculous inflammation involution. Equal efficacy of 3 and 4 drugs was characterized by the same rate of mycobacteriuria continuation and detection of mycobacteria in caverns from the removed tuberculous kidney. The negative effect of medication consisted in increased intolerance of the drugs, involvement of the liver and kidneys, toxico-allergic reactions. Indications for initial use of 4 mycobacterial drugs in new cases of tuberculosis are early forms of tuberculosis of the kidneys in normal nitrogen-excretory function and absence of hepatic insufficiency. This treatment must be recommended with caution for old patients. The conclusion is made that WHO recommendation to use initially four drugs for treatment of urogenital tuberculosis is not well grounded and physicians should decide on the treatment regimen after consideration individual characteristics of the patients.

[Comparative evaluation of therapeutic effects of 3 and 4 antitubercular agents at the initial stage of the treatment of renal tuberculosis]. / Sravnitel'naia otsenka terapevticheskogo vozdeistviia 3 i 4 protivotuberkuleznykh preparatov na initsial'nom étape lecheniia tuberkuleza pochek.

Three groups of the parameters of the therapeutic effects of 3 and 4 antituberculous drugs on renal tuberculous inflammation were identified. The primary effect of 4 drugs was much frequently manifested itself by the normalization of urinalysis and the transfer of cultured to uncultured Mycobacterium tuberculosis (MBT). The equivalent effect of 3 and 4 drugs was characterized by the similar rate of continuation of specific mycobacteriuria, by the detection of MBT in the cavernous contents from the removed tuberculosis-afflicted kidney and by the equivalent morphological characteristics of tuberculous inflammation involution. The negative impact of the therapeutic action of 4-component chemotherapy appeared as a much larger number of cases of intolerance of antituberculous drugs, hepatic and renal failures, and toxic-and-allergic reactions.