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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Main Authors: O. M. Gordeeva, A. M. Tikhonov, S. N. Andreevskaya, E. E. Larionova, N. L. Karpina
Format: Article
Language:Russian
Published: New Terra Publishing House 2022-07-01
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.
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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