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Impact of renal function-based anti-tuberculosis drug dosage adjustment on efficacy and safety outcomes in pulmonary tuberculosis complicated with chronic kidney disease
- Source :
- BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-8 (2019), BMC Infectious Diseases
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- Background Dosages of anti-tuberculosis (TB) drugs are recommended to be adjusted according to renal function for patients complicated with chronic kidney disease (CKD). However, the efficacy and safety outcomes of such renal function-based dosage adjustments are not fully elucidated. Methods We retrospectively reviewed cases of pulmonary TB susceptible to first-line drugs that were treated at Jikei University Daisan Hospital between 2005 and 2014 with standard regimens based on dosage adjustments according to renal function recommended by international guidelines. Patients were divided into four groups, those with no, mild, moderate or severe CKD. In-hospital TB-related mortality, the rate of sputum culture conversion at 2 months, the frequency of adverse events (AEs), for which at least the temporal discontinuation of the suspect drug was required for patient improvement, and the rate of regimen change due to AEs were assessed. Results In the 241 enrolled patients (mean age, 64.1 years; 143 men), fourteen patients (5.8%) died due to TB during their hospitalization. The rate of sputum culture conversion at 2 months was 78.0%. The frequency of in-hospital TB-related death and the conversion rate in the groups did not vary significantly according to CKD severity including those in the non-CKD group (P = 0.310 and P = 0.864). Meanwhile, a total of 70 AEs were observed in 60 patients (24.9%) and the difference between the groups in the overall frequency of AEs was almost significant (P = 0.051). Moreover, for the 154 patients with CKD, severe CKD stage was a significant risk factor for regimen change (OR = 5.92, 95% CI = 1.08–32.5, P = 0.041), as were drug-induced hepatitis and cutaneous reaction (OR = 35.6, 95% CI = 8.70–145, P
- Subjects :
- Adult
Male
0301 basic medicine
medicine.medical_specialty
Tuberculosis
Hospital mortality
030106 microbiology
Antitubercular Agents
Renal function
urologic and male genital diseases
Severity of Illness Index
lcsh:Infectious and parasitic diseases
Sputum culture
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Odds Ratio
Humans
Medicine
lcsh:RC109-216
030212 general & internal medicine
Renal Insufficiency, Chronic
Adverse effect
Tuberculosis, Pulmonary
Aged
Retrospective Studies
Aged, 80 and over
medicine.diagnostic_test
business.industry
Pulmonary tuberculosis
Middle Aged
medicine.disease
Chronic renal insufficiency
Discontinuation
Regimen
Infectious Diseases
Drug-related side effects
Sputum
Female
Chemical and Drug Induced Liver Injury
Glomerular filtration rate
medicine.symptom
business
Research Article
Kidney disease
Subjects
Details
- ISSN :
- 14712334
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- BMC Infectious Diseases
- Accession number :
- edsair.doi.dedup.....dac6a4caf53c20202655673ba79fd33e