Dr Ayesha Akram, Dr Maham Arshad, Dr Irsa Khalid
Objective: The main objective of this research work was to examine the imaging role in the prediction of kidney’s salvage-ability and the early nephrectomy’s role in urinary tract TB (Tuberculosis). Methodology: This research work comprised on 103 patients who were administered from 2012 to 2020. We reviewed the IVUs (Intravenous Urograms). Stratification of the patients was carried out in 3 different groups. Treatment comprised of immediate surgical intervention, described as nephrectomy within 6 weeks of the start of ATT (Anti-TB) therapy and delayed nephrectomy was performed after completing ATT. We applied the Chi square test for acknowledgement of the importance of early nephrectomy. We used the logistic regression analysis for the identification of the factors to predict the salvage-ability of the nephrons. Results: Out of total 103 patients, twenty-three patients were present with early nephrectomy and all patients got complete cure and found with good renal function at follow-up period. Of seventy-six patients who obtained only the ATT, forty-three patients got complete cure and remaining thirty-three patients were deteriorated symptomatically with increase in level of serum creatinine and reduction in GFR. Among thirty-three deteriorated patients, we noticed deterioration in radiological &biochemical findings in twenty-four patients, there was development of flank sinus in 2 patients and there was development of multi-drug resistant tuberculosis. On sub-division of the subjects on the basis of IVUs, it was discovered that those patients with major renal abrasion alone (Group-A) or with involvement of bladder (Group-C) needed either delayed or early nephrectomy and patients present with minor abrasions (Group-B) or involvement of bladder without or with minor abrasions (Group-C) did optimum on ATT. Model of logistic regression stated cavitory abrasion, GFR of less than 20.0ml/min/m2 and statistically significant unfavorable factor was gross hydro-nephrosis and favorable factor was ureteric stricture. Conclusion: In this modern period of ATT, one of the essential methods is nephrectomy. The findings of this research work recommend the application of early nephrectomy for the patients present with major renal abrasions without or with the involvement of bladder, gross hydro-nephrosis and for those patients who are present with GFR of less than 20.0ml/min/m2. Keywords: GFR, ATT, bladder, gross, nephrosis, regression, analysis, nephrectomy, abrasions.