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Acute renal failure complicating rifampicin therapy
J Prakash1, N S Kumar, R K Saxena
1Department of Nephrology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
The Journal of the Association of Physicians of India
|February 12, 2002
Summary
Rifampicin-induced acute renal failure (ARF) is a recognized complication, often occurring upon reintroduction of the drug. While typically manageable with a favorable prognosis, interrupted therapy increases the risk of ARF.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Rifampicin-induced acute renal failure (ARF) is a rare but serious adverse effect.
- Limited systemic data exists on the condition, with most reports being case studies.
Purpose of the Study:
- To analyze the clinical features, course, and outcomes of ARF in patients treated with rifampicin.
- To determine the prevalence and risk factors associated with rifampicin-induced ARF.
Main Methods:
- Retrospective study of 11 cases of ARF following rifampicin retreatment.
- Analysis of clinical presentations, laboratory findings, renal histology, and patient outcomes.
- Comparison of ARF incidence with overall ARF cases hospitalized during the study period.
Main Results:
- Gastrointestinal symptoms, 'flu-like' illness, anemia, leukocytosis, and thrombocytopenia were common.
- Allergic interstitial nephritis and acute tubular necrosis were the primary histopathological findings.
- Renal function recovered in most patients; one mortality due to toxic hepatitis, and one patient required long-term dialysis.
Conclusions:
- Rifampicin-induced ARF is not uncommon, particularly after drug reintroduction.
- The renal prognosis for ARF complicating rifampicin therapy is generally favorable.
- Intermittent or interrupted rifampicin therapy is a significant risk factor for developing ARF.