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Renal tuberculosis is a form of extrapulmonary tuberculosis caused primarily by the bacterium Mycobacterium tuberculosis, which spreads from the lungs through the bloodstream to infect the kidneys. It is a chronic bacterial infection that leads to the formation of granulomatous lesions in the renal tissue, particularly involving the renal cortex and medulla. The infection causes progressive destruction of kidney tissues, often resulting in caseous necrosis and cavitation. The disease can affect one or both kidneys and may extend to the ureters and bladder, causing urinary tract complications such as strictures, dilation, and fibrosis. Symptoms of renal tuberculosis can be insidious and nonspecific, including frequent and painful urination, blood in the urine (hematuria), flank pain, fever, and weight loss.

Diagnosis is often delayed as symptoms mimic other urinary tract infections, but confirmatory tests include urine cultures for Mycobacterium tuberculosis, imaging studies like intravenous urography or CT scans, and sometimes kidney biopsy. Treatment typically involves a prolonged course of antitubercular therapy combined with surgical intervention in advanced cases to remove irreversibly damaged tissue. Early diagnosis and treatment are crucial in preventing complications such as kidney failure or spread of the infection to other organs.