ABSTRACT:
Patients on anti-tuberculosis treatment develop acute kidney injury (AKI) especially in an aging population. This study aimed to calculate the incidence of AKI due to anti-TB drugs and to analyse the outcomes and predictors of renal recovery. Patients on anti-TB treatment during the year 2015 and 2016 were identified and their medical records were reviewed. Acute kidney injury was identified according to the criteria established by the AKI Network, while renal recovery was calculated as a return of serum creatinine to baseline. Predictors of renal recovery were analysed by Cox regression analysis. 61 patients of the age 68 years on anti-TB treatment had AKI with male predominance. 43 (71%) developed AKI within two months of anti-TB treatment, including 3 (5%) with a prior history of rifampin exposure. 30 (26%) had co-morbid chronic kidney disease or end-stage renal disease. The median time of renal recovery was 39.6 days. Factors predicting renal recovery were, presence of fever, rash, and gastro-intestinal disturbance at the onset of AKI. 51 of the 60 patients who recovered from AKI had successful re-introduction or continuation of rifampin. The present study suggests that acute kidney injury is caused by anti-tuberculosis drugs mainly in geriatrics. Some of the patients with acute kidney injury recovered and some of them had permanent renal impairment. Patients with predictable factors of fever, rash, and gastrointestinal disturbance at the onset of acute kidney injury had better renal recovery. Further research efforts should be directed towards better findings related to association of anti-tuberculosis drugs with acute kidney injury and increasing systematic strategies for prevention.