Related Experiment Videos
Acute renal failure due to rifampicin: a study of 25 patients
Thangamani Muthukumar1, Matcha Jayakumar, Edwin M Fernando
1Department of Nephrology, Madras Medical College and Government Hospital, Chennai, India.
Background:
Acute renal failure (ARF) caused by rifampicin typically occurs on intermittent administration. There are isolated case reports and only one series reported in the literature. Systematic data, especially from countries endemic for tuberculosis and leprosy, are sparse.
Methods:
We studied demographic, clinical, biochemical, and histopathologic features and prognosis of 25 consecutive patients with rifampicin-associated ARF admitted from July 1990 to June 2000.
Results:
Rifampicin-associated ARF constituted 2.5% of all cases of ARF seen during the study period. The most common pattern of drug intake resulting in ARF (40%) was ingestion of a single dose preceded by a drug-free period (range, 10 days to 6 years) after a course of daily rifampicin (range, 8 days to 18 months). Onset was with gastrointestinal and flu-like symptoms 4 hours (median) after drug intake. All patients were oliguric. Anemia and thrombocytopenia each occurred in 60% of patients. Acute hepatitis was present in 32%. Among 12 patients who underwent kidney biopsy, 7 patients (58%) had acute interstitial nephritis (AIN). Crescentic glomerulonephritis was seen in 1 patient, and mesangial proliferation, in 3 patients. No single feature at presentation predicted the severity of renal failure. There were no deaths, and all patients recovered renal function.
Conclusion:
Patients with rifampicin-associated ARF were oliguric and presented with gastrointestinal and flu-like symptoms, typically after reintroduction of the drug after a drug-free period. Anemia and thrombocytopenia were common. AIN was the most common biopsy finding. No factor predicted severity, but the renal prognosis was good.
Insights
Rifampicin-associated acute renal failure (ARF) often occurs after drug reintroduction, presenting with flu-like symptoms. While common, acute interstitial nephritis is a frequent finding, but renal prognosis remains good.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Rifampicin-induced acute renal failure (ARF) is typically linked to intermittent drug administration.
- Limited systematic data exists, particularly from tuberculosis and leprosy endemic regions.
Purpose of the Study:
- To investigate the characteristics and prognosis of 25 patients with rifampicin-associated ARF.
- To analyze demographic, clinical, biochemical, and histopathologic features of this condition.
Main Methods:
- Retrospective analysis of 25 consecutive patients with rifampicin-associated ARF.
- Data collected included patient demographics, clinical presentation, biochemical markers, and kidney biopsy findings.
Main Results:
- Rifampicin-associated ARF accounted for 2.5% of all ARF cases.
- The most common trigger was a single dose after a drug-free period (40%), with symptoms appearing median 4 hours post-ingestion.
- Oliguria, anemia, and thrombocytopenia were prevalent; acute interstitial nephritis (AIN) was the most common biopsy finding (58%).
Conclusions:
- Rifampicin-associated ARF typically presents with oliguria and flu-like symptoms, often upon drug reintroduction.
- Anemia, thrombocytopenia, and AIN are common, but renal prognosis is generally favorable with good recovery.