Primary echinococcal disease of the kidney: the case for a more conservative approach

Abstract

Purpose: To evaluate conservative management of renal echinococcosis in cases with normal renal function and active disease.

Patients and methods: From a series of 12 consecutive patients with primary renal echinococcosis, nephrectomy was suggested to 4 patients because of kidney destruction. One patient who denied surgery and 5, in whom serological tests were positive, were given mebendazole for 30 days. 3 patients with no evidence of active disease were not given any medication.

Results: The patient who denied nephrectomy and 1 out of 5 with positive serological tests did not respond to mebendazole treatment. The latter underwent a cyst excision. Thus, 4 responders to mebendazole and 3 who were not given any medication, avoided surgery and continue to have negative serological tests for more than 3 years.

Conclusion: Conservative management and long term follow up are proposed for the non-active or mebendazole-responsive patients. For the non-respondents or the cases with kidney destruction, surgery is the only hope for cure.