Side-effects of antituberculosis drug treatment in patients with chronic renal failure.
Patients with chronic renal failure (CRF) have a high incidence of tuberculosis (TB). Those from the Indian subcontinent are at particular risk. The frequency of side-effects associated with antituberculous treatment in a group of patients with CRF was studied. All cases of TB in patients with CRF occurring over a 13-yr period at the Manchester Royal Infirmary, from 1986-1999, were identified by diagnostic coding, microbiology records and a TB database. The case notes were then reviewed. Twenty-four cases were identified, eight predialysis and 16 requiring regular dialysis. TB occurring in the dialysis group was extrapulmonary in every case. Nineteen of 24 (79%) patients were of Indian subcontinent origin and 14 of 16 (87%) dialysis patients were non-Caucasian. Adverse effects of treatment occurred in two of eight (25%) in the predialysis group and nine of 16 (56%) of the dialysis group. These were most commonly neuropsychiatric (6), hepatic (4) and gastrointestinal (4). Neuropsychiatric symptoms occurred exclusively in dialysis patients. In conclusion, a high incidence of side-effects from antituberculous medication, especially neuropsychiatric, hepatic and gastrointestinal, was identified in patients with chronic renal failure. Careful monitoring for side-effects is essential in this group, and consideration should be given to administering antituberculous chemoprophylaxis to all high-risk groups.
Quantrill
S J
SJ
Dept of Respiratory Medicine, Manchester Royal Infirmary, UK. s.quantrill@ic.ac.uk
Woodhead
M A
MA
Bell
C E
CE
Hardy
C C
CC
Hutchison
A J
AJ
Gokal
R
R
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D056486:Chemical and Drug Induced Liver Injury; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000208:ethnology; D006801:Humans; D007194:India / Q000208:ethnology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000208:ethnology; D008107:Liver Diseases / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000139:chemically induced* / Q000208:ethnology; D012189:Retrospective Studies; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy* / Q000208:ethnology / Q000209:etiology*
D000995:Antitubercular Agents