Source: Annual Congress 2002 - Clinical and social reflections of tubercular disease
Disease area: Respiratory infections

Abstract

This retrospectiv study was performed on 92 patients diagnosed with acute renal failure (ARF) post discontinuous rifampicin treatment for pulmonary tuberculosis. The passage from the continuous treatment (7/7days) to discontinuous RMP treatment triggered the ARF in 77 patients and in 15 cases at the treatment restart after one year of interruption.
The ARF simptomatology has been settled in the first 12 hrs of treatment resumption in 14.13% cases and in 85.87% after 38.5±]8.2hrs. The lumbar pain (in 76.08% of cases), nausea and vomiting (60.86%), abdominal pain (52.17%), flu-like (50%), jaundice (39.13%), diarrhea (30.43%), hypotension (14.13%) were the simptomatology at patients presentation. Confusion and hypertension were only in 7.6% of cases. Renal simptomatology has been settled in 94.56% of cases in normal kidneys. The renal injury evolution was favorable, and significant improvements have been seen after 20 days in serum and urine biological parameters. The antibodies anti-RMP was present in 55.43% serum patients. In 80.39% of them, the presence of antibodies was correlated with high values of gamma-globulins (21,85±]0,49%). The most frequent associated ARF complications were the hemolytic anemia, emphasized by high levels of unconjugated bilirubin and positive Coombs test in 93.3% of patients, and liver injuries (41.69% of cases). Trombocytopenia was registered in 27.7% of cases, infections (28.6%), gastrointestinal complications (11.95%), and cardiovascular complications in 9.78% of cases, latest presented severe forms that lied to the death of patients.
The ARF post discontinuous rifampicin treatment presents a favorable evolution even when is associated with other organ or systems complications.

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L. M. Munteanu, O. O. Golea, M. M. Nicolicioiu, V. M. Tudorache, D. C. Cocarla (Timisoara, Romania). Specific features of acute renal failure in rifampicin treated patients for pulmonary tuberculosis. Eur Respir J 2002; 20: Suppl. 38, 3812

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