{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:04:38Z","timestamp":1790867078959,"version":"4.1.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) patients are at a high risk of tuberculosis (TB), with a relative risk of developing active TB of 10%\u201325%. Similarly, glomerular disease increases the risk of TB due to diminished glomerular filtration rate, proteinuria, and immunosuppression use. Further, the first-line anti-TB drugs are associated with acute kidney injury (AKI) even in patients with normal kidney functions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively identified 10 patients hospitalized with unusual adverse effects of antituberculosis therapy (ATT) from 2013 to 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We found three cases of AKI caused by rifampicin: acute interstitial nephritis, crescentic glomerulonephritis, and heme pigment-induced acute tubular necrosis. We observed rifampicin-induced accelerated hypertension and thrombocytopenia in two patients on maintenance hemodialysis. Isoniazid caused pancreatitis and cerebellitis in two CKD patients, respectively. In a CKD patient, we detected acute gout secondary to pyrazinamide-induced reduced uric acid excretion. We also observed cases of drug rash with eosinophilia and systemic symptoms and hypercalcemia due to immune reconstitution inflammatory syndrome in patients with glomerular disease on ATT. Immediate discontinuation of the offending drug, along with specific and supportive management, led to a recovery in all cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The adverse effects of ATT may be unusually severe and varied in kidney patients due to decreased renal elimination. Early recognition of these adverse effects and timely discontinuation of the offending drug is essential to limit morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijmy.ijmy_33_24","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T15:00:18Z","timestamp":1718722818000},"page":"183-190","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["The Unusual Adverse Effects of Antituberculosis Therapy in Kidney Patients"],"prefix":"10.4103","volume":"13","author":[{"family":"Abdullah","sequence":"first","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manas Ranjan","family":"Behera","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9994-2326","authenticated-orcid":false,"given":"Anupma","family":"Kaul","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pallavi","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narayan","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharmendra Singh","family":"Bhadauria","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manas Ranjan","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshita","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,6,15]]},"reference":[{"key":"R1-20240902","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.kint.2016.01.034","article-title":"Tuberculosis and chronic kidney disease: An emerging global syndemic","volume":"90","author":"Romanowski","year":"2016","journal-title":"Kidney Int"},{"key":"R2-20240902","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.5588\/ijtld.15.0081","article-title":"Risk of active tuberculosis in chronic kidney disease: A systematic review and meta-analysis","volume":"19","author":"Al-Efraij","year":"2015","journal-title":"Int J Tuberc Lung Dis"},{"key":"R4-20240902","doi-asserted-by":"crossref","first-page":"352","DOI":"10.5588\/ijtld.13.0726","article-title":"Impact of chronic renal failure on anti-tuberculosis treatment outcomes","volume":"18","author":"Baghaei","year":"2014","journal-title":"Int J Tuberc Lung Dis"},{"key":"R5-20240902","doi-asserted-by":"crossref","first-page":"7401541","DOI":"10.1155\/2020\/7401541","article-title":"Prevalence, clinical presentation, and outcome of tuberculosis in patients with chronic kidney disease at a tertiary care hospital in Nepal","volume":"2020","author":"Pradhan","year":"2020","journal-title":"Int J Nephrol"},{"key":"R6-20240902","doi-asserted-by":"crossref","first-page":"470","DOI":"10.4103\/1319-2442.256854","article-title":"Clinical profile of tuberculosis in patients with chronic kidney disease: A report from an endemic country","volume":"30","author":"Vikrant","year":"2019","journal-title":"Saudi J Kidney Dis Transpl"},{"key":"R7-20240902","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1053\/j.ajkd.2023.05.005","article-title":"Incidence of and risk factors for active tuberculosis disease in individuals with glomerular disease: A Canadian cohort study","volume":"82","author":"Canney","year":"2023","journal-title":"Am J Kidney Dis"},{"key":"R8-20240902","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1186\/s12879-019-4010-7","article-title":"Impact of renal function-based anti-tuberculosis drug dosage adjustment on efficacy and safety outcomes in pulmonary tuberculosis complicated with chronic kidney disease","volume":"19","author":"Saito","year":"2019","journal-title":"BMC Infect Dis"},{"key":"R9-20240902","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.ijantimicag.2019.06.010","article-title":"Pharmacokinetics of pyrazinamide during the initial phase of tuberculous meningitis treatment","volume":"54","author":"Stemkens","year":"2019","journal-title":"Int J Antimicrob Agents"},{"key":"R10-20240902","doi-asserted-by":"crossref","first-page":"e0141002","DOI":"10.1371\/journal.pone.0141002","article-title":"Pharmacokinetics of isoniazid, pyrazinamide, and ethambutol in newly diagnosed pulmonary TB patients in Tanzania","volume":"10","author":"Denti","year":"2015","journal-title":"PLoS One"},{"key":"R11-20240902","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/s40121-023-00761-w","article-title":"Incidence of and risk factors for acute kidney injury during antituberculosis treatment: A prospective cohort study and literature review","volume":"12","author":"Chang","year":"2023","journal-title":"Infect Dis Ther"},{"key":"R12-20240902","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1053\/ajkd.2002.35675","article-title":"Acute renal failure due to rifampicin: A study of 25 patients","volume":"40","author":"Muthukumar","year":"2002","journal-title":"Am J Kidney Dis"},{"key":"R13-20240902","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1053\/ajkd.1998.v31.pm9428460","article-title":"Rifampicin-associated acute renal failure: Pathophysiologic, immunologic, and clinical features","volume":"31","author":"De Vriese","year":"1998","journal-title":"Am J Kidney Dis"},{"key":"R14-20240902","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1093\/ndt\/13.4.924","article-title":"Rifampicin-induced acute renal failure: A series of 60 patients","volume":"13","author":"Covic","year":"1998","journal-title":"Nephrol Dial Transplant"},{"key":"R15-20240902","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1159\/000046326","article-title":"Rapidly progressive glomerulonephritis due to rifampicin therapy","volume":"90","author":"Yoshioka","year":"2002","journal-title":"Nephron"},{"key":"R16-20240902","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1159\/000044942","article-title":"Crescentic glomerulonephritis due to rifampin treatment in a patient with pulmonary atypical mycobacteriosis","volume":"78","author":"Ogata","year":"1998","journal-title":"Nephron"},{"key":"R17-20240902","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1046\/j.1365-2141.2000.02299.x","article-title":"Glycoprotein Ib\/IX complex is the target in rifampicin-induced immune thrombocytopenia","volume":"110","author":"Pereira","year":"2000","journal-title":"Br J Haematol"},{"key":"R18-20240902","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1007\/BF01714964","article-title":"Immune hemolytic anemia and renal failure associated with rifampicin-dependent antibodies with anti-I specificity","volume":"63","author":"Pereira","year":"1991","journal-title":"Ann Hematol"},{"key":"R19-20240902","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1056\/NEJMcp1810479","article-title":"Immune thrombocytopenia","volume":"381","author":"Cooper","year":"2019","journal-title":"N Engl J Med"},{"key":"R20-20240902","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1016\/j.ekir.2023.02.1096","article-title":"Rifampicin-induced hemolysis and hemoglobin cast nephropathy-clinicopathological study of twenty-six patients","volume":"8","author":"Jansi","year":"2023","journal-title":"Kidney Int Rep"},{"key":"R21-20240902","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1111\/j.1365-2125.1982.tb01390.x","article-title":"Effect of rifampicin on metoprolol and antipyrine kinetics","volume":"13","author":"Bennett","year":"1982","journal-title":"Br J Clin Pharmacol"},{"key":"R22-20240902","doi-asserted-by":"crossref","first-page":"322","DOI":"10.4103\/0971-4065.176145","article-title":"Rifampicin and anti-hypertensive drugs in chronic kidney disease: Pharmacokinetic interactions and their clinical impact","volume":"26","author":"Agrawal","year":"2016","journal-title":"Indian J Nephrol"},{"key":"R23-20240902","first-page":"771","article-title":"Effect of antitubercular medications on blood pressure control in chronic kidney disease patients with tuberculosis: A prospective cohort study","volume":"19","author":"Sharma","year":"2006","journal-title":"J Nephrol"},{"key":"R24-20240902","doi-asserted-by":"crossref","first-page":"90","DOI":"10.4168\/aair.2019.11.1.90","article-title":"Prevalence and clinical features of drug reactions with eosinophilia and systemic symptoms syndrome caused by antituberculosis drugs: A retrospective cohort study","volume":"11","author":"Jung","year":"2019","journal-title":"Allergy Asthma Immunol Res"},{"key":"R25-20240902","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/j.jaip.2017.11.021","article-title":"Antituberculosis drug-associated DRESS: A case series","volume":"6","author":"Allouchery","year":"2018","journal-title":"J Allergy Clin Immunol Pract"},{"key":"R26-20240902","first-page":"360","article-title":"Antitubercular therapy causing drug reaction with eosinophilia and systemic symptoms manifesting multi-organ dysfunction syndrome and death in an elderly patient: A case report with review of literature","volume":"12","author":"Panda","year":"2023","journal-title":"Int J Mycobacteriol"},{"key":"R27-20240902","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1111\/jdv.18808","article-title":"Management and treatment outcome of DRESS patients in Europe: An international multicentre retrospective study of 141 cases","volume":"37","author":"Kridin","year":"2023","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R28-20240902","doi-asserted-by":"crossref","first-page":"229","DOI":"10.18176\/jiaci.0480","article-title":"Spanish guidelines for diagnosis, management, treatment, and prevention of DRESS syndrome","volume":"30","author":"Caba\u00f1as","year":"2020","journal-title":"J Investig Allergol Clin Immunol"},{"key":"R29-20240902","first-page":"139","article-title":"Drug reaction with eosinophilia and systemic symptoms (DRESS): Incidence, pathogenesis and management","volume":"16","author":"Shiohara","year":"2017","journal-title":"Expert Opin Drug Saf"},{"key":"R30-20240902","doi-asserted-by":"crossref","first-page":"309","DOI":"10.4103\/ijmy.ijmy_78_22","article-title":"Treatment and management of hypersensitivity reactions developed against anti-tuberculosis drug","volume":"11","author":"Katran","year":"2022","journal-title":"Int J Mycobacteriol"},{"key":"R31-20240902","doi-asserted-by":"crossref","first-page":"433","DOI":"10.7326\/0003-4819-121-6-199409150-00007","article-title":"Isoniazid-induced acute pancreatitis","volume":"121","author":"Rabassa","year":"1994","journal-title":"Ann Intern Med"},{"key":"R32-20240902","first-page":"314","article-title":"Isoniazid-induced recurrent pancreatitis","volume":"13","author":"Mattioni","year":"2012","journal-title":"JOP"},{"key":"R34-20240902","doi-asserted-by":"crossref","first-page":"218","DOI":"10.4103\/ijri.IJRI_421_19","article-title":"Isoniazid: A rare drug-induced cause for bilateral dentate nuclei hyperintensity","volume":"30","author":"Senthil","year":"2020","journal-title":"Indian J Radiol Imaging"},{"key":"R35-20240902","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.4103\/neuroindia.NI_249_17","article-title":"Isoniazid toxicity presenting as bilateral dentate hyperintensities","volume":"65","author":"Deepesh","year":"2017","journal-title":"Neurol India"},{"key":"R36-20240902","doi-asserted-by":"crossref","first-page":"89","DOI":"10.4103\/ijmy.ijmy_161_17","article-title":"Uric acid levels in patients on antituberculosis drugs in the Southwest region of Cameroon","volume":"7","author":"Thumamo","year":"2018","journal-title":"Int J Mycobacteriol"},{"key":"R37-20240902","first-page":"154","article-title":"Hyperuricemia and arthralgia during pyrazinamide therapy in patients with pulmonary tuberculosis","volume":"22","author":"Inayat","year":"2016","journal-title":"Pak J Chest Med"},{"key":"R38-20240902","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1093\/rheumatology\/kel209","article-title":"Anti-tuberculous therapy-induced crystal arthropathy","volume":"45","author":"Abraham","year":"2006","journal-title":"Rheumatology (Oxford)"},{"key":"R39-20240902","first-page":"695","article-title":"Pyrazinamide-induced hyperuricemia","volume":"39","author":"Pham","year":"2014","journal-title":"P T"},{"key":"R40-20240902","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1620\/tjem.223.199","article-title":"Risk factors for development of paradoxical response during anti-tuberculosis treatment in HIV-negative patients with pleural tuberculosis","volume":"223","author":"Jung","year":"2011","journal-title":"Tohoku J Exp Med"},{"key":"R41-20240902","first-page":"1290","article-title":"Paradoxical response during anti-tuberculosis treatment in HIV-negative patients with pulmonary tuberculosis","volume":"11","author":"Cheng","year":"2007","journal-title":"Int J Tuberc Lung Dis"},{"key":"R42-20240902","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1172\/JCI114609","article-title":"1,25(OH) 2D2 production by T lymphocytes and alveolar macrophages recovered by lavage from normocalcemic patients with tuberculosis","volume":"85","author":"Cadranel","year":"1990","journal-title":"J Clin Invest"}],"container-title":["The International Journal of Mycobacteriology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijmy.ijmy_33_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:37:26Z","timestamp":1787067446000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijmy.ijmy_33_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":40,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/ijmy.ijmy_33_24","relation":{},"ISSN":["2212-5531","2212-554X"],"issn-type":[{"value":"2212-5531","type":"print"},{"value":"2212-554X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2024-02-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}