Problems of anti-tuberculosis therapy in patients on hemodialysis
The objective: to determine possibility of prescribing and safety of various anti-tuberculosis drugs and their combinations as part of a therapeutic or preventive course of anti-tuberculosis therapy (ATBT) in patients with end-stage chronic kidney disease (CKD) receiving hemodialysis replacement the...
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| Format: | Article |
| Language: | Russian |
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New Terra Publishing House
2022-07-01
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| Series: | Туберкулез и болезни лёгких |
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| Online Access: | https://www.tibl-journal.com/jour/article/view/1647 |
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| author | O. M. Gordeeva A. M. Tikhonov S. N. Andreevskaya E. E. Larionova N. L. Karpina |
| author_facet | O. M. Gordeeva A. M. Tikhonov S. N. Andreevskaya E. E. Larionova N. L. Karpina |
| author_sort | O. M. Gordeeva |
| collection | DOAJ |
| description | The objective: to determine possibility of prescribing and safety of various anti-tuberculosis drugs and their combinations as part of a therapeutic or preventive course of anti-tuberculosis therapy (ATBT) in patients with end-stage chronic kidney disease (CKD) receiving hemodialysis replacement therapy in the settings with high prevalence of drug resistant strains of Mycobacterium tuberculosis.Subjects and Methods. 42 patients receiving hemodialysis replacement therapy were followed-up by Central Tuberculosis Research Institute: of them, 31 (73.8%) had active tuberculosis and 11 (26.2%) had residual post-tuberculous changes in the respiratory organs. During the follow-up, the nature and severity of adverse reactions to anti-tuberculosis drugs were assessed.Results. In the patients with end-stage CKD suffering from respiratory tuberculosis, drug resistant strains prevailed – 68.2%. Some of adverse events developed when taking anti-tuberculosis drugs were as follows: deterioration of uremia in 20.5% of cases, cardiovascular complications – in 17.9%, and neurotoxic reactions – in 15.4%. Progression of uremia occurred more often in the followed-up patients taking anti-tuberculosis drugs versus hepatotoxic reactions (p = 0.02). When treating tuberculosis patients with end-stage CKD, isoniazid was discontinued due to adverse events in 12.8% of cases and pyrazinamide in 12.8% of cases, other drugs were discontinued less frequently. Compilation of individual regimens of anti-tuberculosis drugs with the consideration of drug susceptibility testing results, contraindications, and concomitant diseases made it possible to provide an adequate anti-tuberculosis therapy for patients with end-stage CKD with tuberculosis infection in 92.9% of cases for a period of more than 6 months. |
| format | Article |
| id | doaj-art-176187f5c3904cb2972fcffa4e8744e7 |
| institution | DOAJ |
| issn | 2075-1230 2542-1506 |
| language | Russian |
| publishDate | 2022-07-01 |
| publisher | New Terra Publishing House |
| record_format | Article |
| series | Туберкулез и болезни лёгких |
| spelling | doaj-art-176187f5c3904cb2972fcffa4e8744e72025-08-20T03:02:41ZrusNew Terra Publishing HouseТуберкулез и болезни лёгких2075-12302542-15062022-07-011006253010.21292/2075-1230-2022-100-6-25-301642Problems of anti-tuberculosis therapy in patients on hemodialysisO. M. Gordeeva0A. M. Tikhonov1S. N. Andreevskaya2E. E. Larionova3N. L. Karpina4Central Tuberculosis Research InstituteCentral Tuberculosis Research InstituteCentral Tuberculosis Research InstituteCentral Tuberculosis Research InstituteCentral Tuberculosis Research InstituteThe objective: to determine possibility of prescribing and safety of various anti-tuberculosis drugs and their combinations as part of a therapeutic or preventive course of anti-tuberculosis therapy (ATBT) in patients with end-stage chronic kidney disease (CKD) receiving hemodialysis replacement therapy in the settings with high prevalence of drug resistant strains of Mycobacterium tuberculosis.Subjects and Methods. 42 patients receiving hemodialysis replacement therapy were followed-up by Central Tuberculosis Research Institute: of them, 31 (73.8%) had active tuberculosis and 11 (26.2%) had residual post-tuberculous changes in the respiratory organs. During the follow-up, the nature and severity of adverse reactions to anti-tuberculosis drugs were assessed.Results. In the patients with end-stage CKD suffering from respiratory tuberculosis, drug resistant strains prevailed – 68.2%. Some of adverse events developed when taking anti-tuberculosis drugs were as follows: deterioration of uremia in 20.5% of cases, cardiovascular complications – in 17.9%, and neurotoxic reactions – in 15.4%. Progression of uremia occurred more often in the followed-up patients taking anti-tuberculosis drugs versus hepatotoxic reactions (p = 0.02). When treating tuberculosis patients with end-stage CKD, isoniazid was discontinued due to adverse events in 12.8% of cases and pyrazinamide in 12.8% of cases, other drugs were discontinued less frequently. Compilation of individual regimens of anti-tuberculosis drugs with the consideration of drug susceptibility testing results, contraindications, and concomitant diseases made it possible to provide an adequate anti-tuberculosis therapy for patients with end-stage CKD with tuberculosis infection in 92.9% of cases for a period of more than 6 months.https://www.tibl-journal.com/jour/article/view/1647anti-tuberculosis therapyhemodialysisdrug resistance of tuberculous mycobacteriaadverse events |
| spellingShingle | O. M. Gordeeva A. M. Tikhonov S. N. Andreevskaya E. E. Larionova N. L. Karpina Problems of anti-tuberculosis therapy in patients on hemodialysis Туберкулез и болезни лёгких anti-tuberculosis therapy hemodialysis drug resistance of tuberculous mycobacteria adverse events |
| title | Problems of anti-tuberculosis therapy in patients on hemodialysis |
| title_full | Problems of anti-tuberculosis therapy in patients on hemodialysis |
| title_fullStr | Problems of anti-tuberculosis therapy in patients on hemodialysis |
| title_full_unstemmed | Problems of anti-tuberculosis therapy in patients on hemodialysis |
| title_short | Problems of anti-tuberculosis therapy in patients on hemodialysis |
| title_sort | problems of anti tuberculosis therapy in patients on hemodialysis |
| topic | anti-tuberculosis therapy hemodialysis drug resistance of tuberculous mycobacteria adverse events |
| url | https://www.tibl-journal.com/jour/article/view/1647 |
| work_keys_str_mv | AT omgordeeva problemsofantituberculosistherapyinpatientsonhemodialysis AT amtikhonov problemsofantituberculosistherapyinpatientsonhemodialysis AT snandreevskaya problemsofantituberculosistherapyinpatientsonhemodialysis AT eelarionova problemsofantituberculosistherapyinpatientsonhemodialysis AT nlkarpina problemsofantituberculosistherapyinpatientsonhemodialysis |