IS NEPHRECTOMY ALWAYS INDICATED FOLLOWING A DIAGNOSIS OF UNILATERAL RENAL TUBERCULOSIS?

The possibility that renal tuberculosis, once it has reached the point at which diagnosis is beyond question, ever heals has received considerable discussion during the last fifteen years. In 1920 Chute1 reviewed three cases that occurred in his practice; he considered that there were indications in occasional cases that tuberculous processes of the kidney healed. He pointed out how such a belief is necessary if one is to accept the hypothesis of the hematogenous route of the infection. He says:I believe we must assume that tubercle bacilli are brought in approximately equal numbers to both kidneys, that small cortical tuberculous infections are common and that far from going on to complete destruction of every kidney that is infected they are probably promptly stamped out in the greater majority of instances. The generous blood supply of the kidney allows it to overcome perhaps the greater number of infections while