Division of Nephrology, Department of Medicine, University of the Philippines Manila - Philippine General Hospital, Taft Avenue, Ermita, 1000, Manila, Philippines.
BMC Urol. 2021 Sep 9;21(1):125. doi: 10.1186/s12894-021-00888-3.
Genitourinary tuberculosis (GUTB) is known to cause high rates of structural organ damage, however, literature on its biochemical manifestations is limited. Additionally, local studies in the Philippine setting, where cases are rampant, are few and dated. This study aimed to determine the serologic and urinary profile of patients with GUTB admitted at a tertiary hospital within January 2009 to March 2020 and their association with short-term outcomes.
This retrospective study included 112 patients with laboratory-confirmed GUTB (i.e., positivity in acid-fast smear, polymerase chain reaction, culture, or histology). Demographic data, clinical characteristics, laboratory and radiologic findings, histopathology reports, treatment, and short-term outcomes were recorded.
Bladder (54.5%) and kidney (36.4%) were the most affected organs. The male:female ratio was 1:1.15, and the mean age was 35.79 ± 18.29 years. Weakness (14.29%) was the most common chief complaint. A majority presented with anemia (83.04%), while several had leukocytosis (41.96%) and thrombocytosis (26.79%). Hypoalbuminemia (58.10%), impairment of renal function (36.94%), and electrolyte abnormalities such as hyponatremia (50.93%), hypercalcemia (20.19%), and hypokalemia (21.82%) were common. Proteinuria (67.96%) and pyuria (67.96%) were the most frequent abnormal findings, followed by hematuria (51.46%), acidic urine (45.63%) and low specific gravity (31.07%). Age, leukocytosis, and the need for pressors were all significantly associated with mortality (p values of <0.001, 0.010, and <0.001, respectively).
The young age at presentation with severe clinical and laboratory manifestations may reflect local epidemiology as TB continues to be widespread in the country. Apart from the more commonly cited abnormalities in literature, multiple electrolyte imbalances and urinary concentration defects were also observed in many cases, possibly indicating tubulointerstitial involvement-a complication increasingly mentioned in case reports. As several patient characteristics were found to be associated with the high mortality rates observed in the study, further research is recommended to explore predictive modeling.
尿路生殖系统结核（GUTB）已知会导致高比例的结构器官损伤，但有关其生化表现的文献有限。此外，在病例猖獗的菲律宾，当地的研究很少且时间久远。本研究旨在确定 2009 年 1 月至 2020 年 3 月期间在一家三级医院住院的 GUTB 患者的血清学和尿液特征，并探讨其与短期预后的关系。
这是一项回顾性研究，共纳入 112 例经实验室证实的 GUTB 患者（即抗酸染色、聚合酶链反应、培养或组织学检查阳性）。记录患者的人口统计学数据、临床特征、实验室和影像学检查结果、组织病理学报告、治疗和短期预后。
膀胱（54.5%）和肾脏（36.4%）是最常受累的器官。男女比例为 1:1.15，平均年龄为 35.79±18.29 岁。乏力（14.29%）是最常见的主诉症状。大多数患者表现为贫血（83.04%），部分患者白细胞增多（41.96%）和血小板增多（26.79%）。低白蛋白血症（58.10%）、肾功能不全（36.94%）和电解质异常，如低钠血症（50.93%）、高钙血症（20.19%）和低钾血症（21.82%）较为常见。蛋白尿（67.96%）和脓尿（67.96%）是最常见的异常发现，其次是血尿（51.46%）、酸性尿液（45.63%）和低比重（31.07%）。年龄、白细胞增多和需要升压药治疗与死亡率显著相关（p 值分别<0.001、0.010 和<0.001）。
年轻的发病年龄伴有严重的临床和实验室表现可能反映了当地的流行情况，因为结核病在该国仍广泛存在。除了文献中更常提到的异常情况外，许多患者还存在多种电解质失衡和尿液浓缩缺陷，这可能表明存在肾小管间质受累——这种并发症在病例报告中越来越多地被提及。由于研究中观察到的几个患者特征与高死亡率相关，建议进一步研究以探索预测模型。
