TB treatment shown effective in CKD patients
Researchers in India conducted a 12 month study of 572 CKD patients, 33 of whom also had tuberculosis. The study showed ATT to be effective in 84.4 percent of the subjects, although the response to treatment was not as robust as in patients without CKD, according to RenalandUrologyNews.com.
The study also suggests that physicians may need to monitor and adjust the dosing intervals of ATT for those who have impaired kidney functions.
Gastritis was the most common complication from using ATT in CKD patients, followed by drug-induced hepatitis. A minority of the CKD patients in the study also suffered from a worsening of kidney function.
"TB is endemic in the developing world and India has the second largest burden of disease," lead investigator Dr. Teny Mathew John said, RenalandUrologyNews.com reports. "Chronic kidney disease is an immunosuppressed state like HIV. We had many patients with CKD presenting with unexplained fever and weight loss and when evaluated had radiological, biochemical, or microbiological evidence of TB," he continued. "Some had response to empirical anti TB treatment."
TB management in CKD patients is not considered to be well-defined and guidelines generally do not dictate a formal treatment plan.
"TB should be one of the important differential diagnoses in a CKD patient with unexplained fever and weight loss," John said, according to RenalandUrologyNews.com. "Genitourinary TB in CKD can present as strictures and scarring and usually the radiological findings are quite specific. The outcome of TB treatment is comparable to that of the general population although the treatment duration is prolonged, needing up to one year."