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The major etiology is rifampicin-induced acute interstitial nephritis. However, the standard management \nof AKI induced by anti-TB drugs has yet to be established. Methods We retrospectively reviewed patients with TB who developed AKI after starting standard anti-TB treatment between 2006 and 2016 at a single TB center. \nThe clinical characteristics and the management are described. Results Among 1,430 patients with active TB, 15 (1.01%) developed AKI. The mean age (standard devia-tion) was 61 years (18). The median (interquartile range) time to AKI development was 45 days (21-54 days). The median serum creatinine level before anti-TB treatment was 0.7 mg/dL (0.5-1.4 mg/dL), whereas the median peak serum creatinine level after AKI onset was 4.0 mg/dL (3.08-5.12 mg/dL). Five patients (33.3%) were pathologically confirmed as having acute interstitial nephritis (AIN), and 7 patients (46.7%) had a clinical diagnosis of the disease. 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A Case Series of Acute Kidney Injury During Anti-tuberculosis Treatment
http://hdl.handle.net/10069/38900
http://hdl.handle.net/10069/38900b4fb62fb-06be-40d3-91b4-9d399284b020
名前 / ファイル | ライセンス | アクション |
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IntMed58_521.pdf (303.4 kB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2019-03-26 | |||||
タイトル | ||||||
タイトル | A Case Series of Acute Kidney Injury During Anti-tuberculosis Treatment | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Acute interstitial nephritis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Acute kidney injury | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Rifampicin | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Sakashita, Kentaro
× Sakashita, Kentaro× Murata, Kengo× Takahashi, Yukiko× Yamamoto, Miake× Oohashi, Kana× Sato, Yu× Kitazono, Miyako× Wada, Akihiko× Takamori, Mikio |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Objective The standard anti-tuberculosis (TB) regimen occasionally causes acute kidney injury (AKI). The major etiology is rifampicin-induced acute interstitial nephritis. However, the standard management of AKI induced by anti-TB drugs has yet to be established. Methods We retrospectively reviewed patients with TB who developed AKI after starting standard anti-TB treatment between 2006 and 2016 at a single TB center. The clinical characteristics and the management are described. Results Among 1,430 patients with active TB, 15 (1.01%) developed AKI. The mean age (standard devia-tion) was 61 years (18). The median (interquartile range) time to AKI development was 45 days (21-54 days). The median serum creatinine level before anti-TB treatment was 0.7 mg/dL (0.5-1.4 mg/dL), whereas the median peak serum creatinine level after AKI onset was 4.0 mg/dL (3.08-5.12 mg/dL). Five patients (33.3%) were pathologically confirmed as having acute interstitial nephritis (AIN), and 7 patients (46.7%) had a clinical diagnosis of the disease. All anti-TB drugs were stopped, and steroids were administered to 5 (100%) patients with pathologically confirmed AIN and 3 (42.8%) patients with clinically diagnosed AIN. The renal function was normalized in 12 patients (80.0%) after restarting anti-TB treatment without rifampicin (n=12) or isoniazid (n=1). Two patients died due to severe renal failure after restarting rifampicin. Conclusion Rifampicin is the leading cause of AKI. Levofloxacin may be an alternative to rifampicin thanks to its safety and potency. Restarting anti-TB treatment without rifampicin and short-term steroid administration may be a feasible management for AKI. |
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書誌情報 |
Internal Medicine 巻 58, 号 4, p. 521-527, 発行日 2019-02-15 |
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出版者 | ||||||
出版者 | 日本内科学会 | |||||
出版者別言語 | ||||||
Japanese Society of Internal Medicine | ||||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 09182918 | |||||
EISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 13497235 | |||||
DOI | ||||||
関連タイプ | isIdenticalTo | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.2169/internalmedicine.0813-18 | |||||
権利 | ||||||
権利情報 | c 2019 The Japanese Society of Internal Medicine. The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Internal Medicine, 58(4), pp.521-527; 2019 |