Renal tuberculosis has a slow onset. The primary focus is almost exclusively in the lungs, followed by the joints and intestines, mostly in young adults aged 20-40 years, and rarely in young children and the elderly. It is more common in men than in women. About 90% are unilateral lesions. Typical clinical manifestations are as follows: (a) Urinary frequency, urgency, and painful urination: The initial symptom is urinary frequency, which is often the chief complaint at the time of consultation. Due to the stimulation of tuberculosis bacteriuria and tuberculous cystitis, the number of urination gradually increases from 3-5 times a day to more than 10-20 times a day, with urinary urgency and painful urination, and in the late stage when the bladder is severely contracted, urination can reach dozens of times a day. (B) Hematuria and pus urine: Hematuria can be visual or microscopic, but terminal hematuria is predominant and often occurs after frequent urination. Pusuria is manifested by different degrees of cloudiness of the urine, and in severe cases, it is in the form of washed rice, and it can also be pus and blood urine. (iii) Pain and masses in the kidney area: there is usually no obvious back pain, but pain or palpable masses in the kidney area may occur when there is severe destruction of a huge abscess kidney, secondary infection or spread of lesions to the perirenal area. (iv) About 90% of male patients have male genital tuberculosis. (e) Systemic symptoms: When renal tuberculosis is severely damaged, pus accumulates or combined with active tuberculosis lesions in other organs, systemic symptoms such as wasting, weakness, low fever and night sweats may appear. In case of severe hydronephrosis on the opposite side of bilateral or unilateral renal tuberculosis, symptoms of chronic renal insufficiency, such as swelling, anemia, nausea, vomiting, oliguria or anuria, may appear. The following tests are needed to diagnose renal tuberculosis: (a) Routine urinalysis: most white blood cells, red blood cells and a small amount of protein. (ii) urine bacteriological examination: morning urine sediment smear for Mycobacterium tuberculosis, three times in a row, repeated if necessary; the positive rate is 50%-70%. Urine culture of Mycobacterium tuberculosis can have a positive rate of 80%-90%. (c) Polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay can improve the diagnosis rate of tuberculosis. (iv) Radiological examination: abdominal plain film shows calcification, stones and kidney morphology. Intravenous urography can show typical worm-like destruction of renal calyces and pelvis, or cotton peach-like cavity shadow, and in severe cases, the affected kidney does not appear. Retrograde pyelogram can show the destruction of the kidney. (E) Cystoscopy: The bladder triangle and the affected periureter are seen to be congested and edematous with light yellow tuberculous nodules or ulcers and granulomas. This examination should not be done in cases of bladder contracture or acute inflammation. (vi) Ultrasound and CT examination: ultrasound can show disorganized renal structure, pus cavity and contralateral hydronephrosis; CT is better than intravenous urography for the diagnosis of advanced lesions and can show renal cortical cavity, calcification and ureter with thickened walls.