{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T05:10:45Z","timestamp":1779253845426,"version":"3.51.4"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Science Research Project of Hebei","award":["20250836"],"award-info":[{"award-number":["20250836"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Renal tuberculosis is a chronic granulomatous, infectious kidney disease caused by tuberculosis infection, often leading to ureteral tuberculosis, bladder tuberculosis, prostate tuberculosis and genital tract tuberculosis. Its typical pathologic changes are tuberculous nodule formation accompanied by different degrees of caseous necrosis. In recent years, the incidence of atypical renal tuberculosis has increased significantly, with extremely high rates of misdiagnosis and missed diagnosis. Prolonged delays in diagnosis and treatment have led to severe consequences such as renal failure, warranting high priority attention. Even in cases of early-diagnosed renal tuberculosis that achieve \u201cclinical cure\u201d following standardized, full-course anti-tuberculosis drug treatment, some patients still experience severe or even complete renal impairment. Pathological diagnosis can be used to confirm renal tuberculosis. However, what is the pathological outcome after prolonged anti-tuberculosis drug treatment? Does renal tuberculosis complicated by other kidney diseases exhibit specific pathological manifestations? Why does renal function loss occur despite achieving clinical cure? This case report provides answers to these questions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 58-year-old female patient with advanced renal tuberculosis was performed nephrectomy ultimately due to loss of renal function even after 4\u202fyears of anti-tuberculosis drug treatment. During the treatment for left renal tuberculosis, the patient experienced recurrent left renal calculi and underwent three ureteroscopic lithotripsy procedures along with ureteral stent placement for hydronephrosis drainage. Postoperative pathological changes revealed chronic nephritis, extensive tubular atrophy, glomerulosclerosis, accompanied by renal abscesses and cyst formation. However, given the positive\n                      <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                      culture 4\u202fyears ago, combined with CT imaging findings and a positive T-SPOT.TB test, renal tuberculosis was definitively diagnosed based on positive GeneXpert and TB-DNA PCR results from renal tissue samples, which suggests that\n                      <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                      persists in the renal tissue despite 4\u202fyears of antituberculosis treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Renal tuberculosis complicated by recurrent kidney stones and hydronephrosis, along with suspected urinary tract infection, can lead to atypical pathological changes in renal tissue and exacerbate renal dysfunction. TB-DNA PCR and GeneXpert testing of renal tissue aid in establishing a pathogenetic diagnosis, thereby enhancing the efficacy of pathological diagnosis for renal tuberculosis. Alongside effective, full-course anti-tuberculosis drug therapy and adequate renal pelvic drainage, timely treatment of comorbidities such as renal calculi and urinary tract infections is essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1809830","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:49:02Z","timestamp":1779252542000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: A case of advanced renal tuberculosis with recurrent \u201ckidney stones\u201d and specific pathological manifestations"],"prefix":"10.3389","volume":"13","author":[{"given":"Chongbin","family":"Li","sequence":"first","affiliation":[{"name":"Department of Urology, Hebei Chest Hospital","place":["Shijiazhuang, China"]},{"name":"Department of Urology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziyi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yalin","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Urology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guiyun","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hebei Chest Hospital","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianzhen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology, Hebei Chest Hospital","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Urology, Hebei Chest Hospital","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"ref1","first-page":"711","volume-title":"Diagnosis and Treatment Guidelines for Urology and Andrology Diseases in China","author":"Huang","year":"2022"},{"key":"ref2","volume-title":"WHO Consolidated Guidelines on Tuberculosis. Module 3: Diagnosis-Rapid Diagnostics for Tuberculosis Detection, Third Edition","year":"2024"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.ijid.2018.07.007","article-title":"Detection of Mycobacterium tuberculosis in urine by Xpert MTB\/RIF ultra: a useful adjunctive diagnostic tool in HIV-associated tuberculosis","volume":"75","author":"Atherton","year":"2018","journal-title":"Int J Infect Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1007\/s10096-020-04052-x","article-title":"Comparison of the CapitalBio Mycobacterium RT-PCR detection test and Xpert MTB\/RIF assay for diagnosis of renal tuberculosis","volume":"40","author":"Liu","year":"2021","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"ref5","first-page":"768","volume-title":"Allgemeine und Spezielle Pathologie. Translated by Wu Zhongbi","author":"Reid","year":"2007"},{"key":"ref6","first-page":"376","volume-title":"Pathology","author":"Li","year":"2003"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"5311","DOI":"10.1097\/MS9.0000000000003576","article-title":"Isolated renal tuberculosis presenting as staghorn calculi and hydronephrosis-a case report and literature review","volume":"87","author":"Abera","year":"2025","journal-title":"Ann Med Surg (Lond)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1186\/s40001-025-02783-1","article-title":"Analysis of the onset characteristics and diagnosis of 217 cases of renal tuberculosis","volume":"30","author":"Li","year":"2025","journal-title":"Eur J Med Res"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e95735","DOI":"10.7759\/cureus.95735","article-title":"When a forgotten kidney stone breaks free: an unexpected case of spontaneous nephrocutaneous fistula","volume":"17","author":"Shukr","year":"2025","journal-title":"Cureus"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1186\/s12879-025-12139-z","article-title":"Clinical analysis of the onset characteristics and inducing factors of atypical renal tuberculosis","volume":"26","author":"Li","year":"2026","journal-title":"BMC Infect Dis"},{"key":"ref11","first-page":"511, 512, 522","volume-title":"Immunohistochemical Pathological Diagnosis","author":"Wu","year":"2009"},{"key":"ref12","first-page":"508, 515, 520, 521","volume-title":"Pathology Technology","author":"Wang","year":"2000"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1430","DOI":"10.1164\/rccm.200409-1200OC","article-title":"Rate of reinfection tuberculosis after successful treatment is higher than rate of new tuberculosis","volume":"171","author":"Verver","year":"2005","journal-title":"Am J Respir Crit Care Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.47391\/JPMA.20719","article-title":"Colorenal fistulae: a rare but fatal presentation of renal tuberculosis in a paediatric patient","volume":"75","author":"Mahar","year":"2025","journal-title":"J Pak Med Assoc"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1809830\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:49:30Z","timestamp":1779252570000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1809830\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":14,"alternative-id":["10.3389\/fmed.2026.1809830"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1809830","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"article-number":"1809830"}}