Chemotherapy of Tuberculosis for Patients with Renal Impairment

Ellard, G. A.

doi:10.1159/000187310

Cited by 44 publications

(35 citation statements)

References 52 publications

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“…81 82 Pharmacokinetic studies of isoniazid in renal failure, however, suggest that even though the half-life of isoniazid is increased by about 45% in slow acetylators, this does not lead to significant adverse events necessitating dosage reduction, and therapeutic drug monitoring is not thought to be necessary. 83 Furthermore, there is evidence to suggest that administering isoniazid in reduced doses may lead to reduced potency and risk the development of resistance. 84 …”

Section: Isoniazid (H)mentioning

confidence: 99%

“…85 Reported side effects for rifampicin do not appear to occur with significantly increased frequency in patients with CKD or on dialysis, although rifampicin has been cited as a rare cause of acute renal failure. 86 As such, there is widespread agreement that the dose of rifampicin need not be altered in renal impairment 83 and that drug levels need not be monitored.…”

Section: Rifampicin (R)mentioning

confidence: 99%

“…83 Serum monitoring should be done and trough levels should be less than 1.0 mg/ml at 24 h post-dose without dialysis. Isoniazid and rifampicin may be given intravenously where absorption is compromised.…”

Section: Ethambutol (E)mentioning

confidence: 99%

“…83 Streptomycin causes significant vestibular toxicity but less nephrotoxicity compared with the other aminoglycosides. There is an increase in elimination time with increasing age and declining renal function.…”

Section: Aminoglycosidesmentioning

confidence: 99%

“…Ethambutol can be given at a dose of 15e25 mg/kg three times weekly for patients on regular haemodialysis. Some authorities recommended dosing 4e6 h before haemodialysis, 83 while others recommend post-dialysis treatment using the same doses, avoiding loss of drugs during dialysis and facilitating adherence. 1 73 102…”

Section: Patients With Ckd Not On Dialysismentioning

confidence: 99%

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Guidelines for the prevention and management of Mycobacterium tuberculosis infection and disease in adult patients with chronic kidney disease

2010

Thorax

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Section: Isoniazid (H)mentioning

confidence: 99%

Section: Rifampicin (R)mentioning

confidence: 99%

Section: Ethambutol (E)mentioning

confidence: 99%

Section: Aminoglycosidesmentioning

confidence: 99%

Section: Patients With Ckd Not On Dialysismentioning

confidence: 99%

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Guidelines for the prevention and management of Mycobacterium tuberculosis infection and disease in adult patients with chronic kidney disease

2010

Thorax

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Extracorporeal treatments for isoniazid poisoning: Systematic review and recommendations from the EXTRIP workgroup

et al. 2021

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Isoniazid toxicity from self‐poisoning or dosing errors remains common in regions of the world where tuberculosis is prevalent. Although the treatment of isoniazid poisoning is centered on supportive care and pyridoxine administration, extracorporeal treatments (ECTRs), such as hemodialysis, have been advocated to enhance elimination of isoniazid. No systematic reviews or evidence‐based recommendations currently exist on the benefit of ECTRs for isoniazid poisoning. The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup systematically collected and rated the available evidence on the effect of and indications for ECTRs in cases of isoniazid poisoning. We conducted a systematic review of the literature, screened studies, extracted data on study characteristics, outcomes, and measurement characteristics, summarized findings, and formulated recommendations following published EXTRIP methods. Forty‐three studies (two animal studies, 34 patient reports or patient series, and seven pharmacokinetic studies) met inclusion criteria. Toxicokinetic or pharmacokinetic analysis was available for 60 patients, most treated with hemodialysis (n = 38). The workgroup assessed isoniazid as “Moderately Dialyzable” by hemodialysis for patients with normal kidney function (quality of evidence = C) and “Dialyzable” by hemodialysis for patients with impaired kidney function (quality of evidence = A). Clinical data for ECTR in isoniazid poisoning were available for 40 patients. Mortality of the cohort was 12.5%. Historical controls who received modern standard care including appropriately dosed pyridoxine generally had excellent outcomes. No benefit could be extrapolated from ECTR, although there was evidence of added costs and harms related to the double lumen catheter insertion, the extracorporeal procedure itself, and the extracorporeal removal of pyridoxine. The EXTRIP workgroup suggests against performing ECTR in addition to standard care (weak recommendation, very low quality of evidence) in patients with isoniazid poisoning. If standard dose pyridoxine cannot be administered, we suggest performing ECTR only in patients with seizures refractory to GABAA receptor agonists (weak recommendation, very low quality of evidence).

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Drug Administration and Pharmacogenomics in Children Receiving Acute or Chronic Renal Replacement Therapy

Blowey

Leeder

2011

Pediatric Dialysis

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Chemotherapy of Tuberculosis for Patients with Renal Impairment

Cited by 44 publications

References 52 publications

Guidelines for the prevention and management of Mycobacterium tuberculosis infection and disease in adult patients with chronic kidney disease

Guidelines for the prevention and management of Mycobacterium tuberculosis infection and disease in adult patients with chronic kidney disease

Extracorporeal treatments for isoniazid poisoning: Systematic review and recommendations from the EXTRIP workgroup

Drug Administration and Pharmacogenomics in Children Receiving Acute or Chronic Renal Replacement Therapy

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