rifampin and Acute-Kidney-Injury

To develop the 'Stronger Towns Index': a deprivation index that took into account characteristics of areas encompassing towns that may be eligible for redevelopment funding and explore how this index was associated with self-rated health and migration within England between 2001 and 2011.. There were areas in the lowest deciles of Town Strength who did not receive funding. After multiple adjustment, LS members living in areas with higher deciles were significantly more likely (7% to 38%) to report good health than those in the lowest decile in 2001. Remaining in the same decile between 2001 and 2011 was associated with 7% lower odds of good self-rated health in 2011.. It is important to consider health in towns when allocating funding. Areas in the Midlands may have missed out on funding which might help mitigate poor health.. Ferritin levels <30µg/L were associated with unexplained infertility and might be screened in the future. Further studies with a focus on iron deficiency and iron treatment on women with unexplained infertility are warranted.. This EGM provides a valuable resource for researchers, policy-makers and the public to access the available evidence on the determinants of various COVID-19 health-related behaviours. The map can also be used to help guide research commissioning, by evidence synthesis teams and evidence intermediaries to inform policy during the ongoing pandemic and potential future outbreaks of COVID-19 or other respiratory infections. Evidence included in the map will be explored further through a series of systematic reviews examining the strength of the associations between malleable determinants and the uptake and maintenance of individual protective behaviours.. Patients with polymicrobial bloodstream infections are typically critically ill and harbor multidrug-resistant bacteria. Thus, to minimize mortality rate in critically ill patients, changes in infectious flora should be monitored, antibiotics selected reasonably, and invasive procedures reduced.. Altogether, these findings clearly revealed the great potential of the in vitro biological activity of linseed extract as a safe source for combatting multidrug-resistant. In this work, the capture of carbon dioxide using a dense hollow fiber membrane was studied experimentally and theoretically. The factors affecting the flux and recovery of carbon dioxide were studied using a lab-scale system. Experiments were conducted using a mixture of methane and carbon dioxide to simulate natural gas. The effect of changing the CO. Persistent gender and racial disparities in high-impact medical and critical care journals underscore the need to revise policies and strategies to encourage greater diversity in critical care research.. Thirty evaluable patients were enrolled. Median age was 60.5 years. Median follow-up for all patients was 17 months. Ten patients (33%) experienced grade ≥ 3 treatment-related adverse events, the most common being neutropenia and diarrhea; 50% required ≥ 1 dose reduction. The disease control rate was 90% (progressive disease: 10%, partial response: 23%, stable disease: 67%). There was zero treatment-related mortality. Twenty-two patients (73%, 90% CI 57-86; p = 0.008) completed all chemotherapy and surgery. Two patients (9%) who successfully underwent resection had minor postoperative complications. Median length of hospital stay was 4 days. Median RFS was 7.1 months. Median OS for the entire cohort was 24 months and was not reached in patients who underwent surgical resection.. Neoadjuvant treatment with gemcitabine, cisplatin, and nab-paclitaxel is feasible and safe prior to resection of intrahepatic cholangiocarcinoma and does not adversely impact perioperative outcomes.

Topics: Acetogenins; Acute Disease; Acute Kidney Injury; Administration, Intravenous; Aged; Albumins; Alcoholism; Aldehyde Dehydrogenase; Aldehyde Dehydrogenase, Mitochondrial; alpha-Glucosidases; Anemia; Animals; Anthozoa; Anti-Bacterial Agents; Anti-Infective Agents; Antibodies, Bacterial; Antigens, Bacterial; Antihypertensive Agents; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Antioxidants; Apoptosis; Ascites; Asthma; Bacteria; beta-Lactamases; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Binding Sites; Biological Availability; Biomass; Borderline Personality Disorder; Brain; Brucella abortus; Brucella melitensis; Brucellosis; Calcium; Carbapenems; Case-Control Studies; Caseins; Cattle; CD8-Positive T-Lymphocytes; Ceftaroline; Cell Line; Cell Line, Tumor; Cell Physiological Phenomena; Cell Proliferation; Cephalosporins; Chemotherapy, Adjuvant; China; Chitin; Chlorella; Chlorophyll; Chlorophyll A; Chlorophyta; Cholangiocarcinoma; Cisplatin; Conotoxins; Contrast Media; Conus Snail; Cross-Sectional Studies; Cytokines; Decapodiformes; Deoxycytidine; Diagnostic and Statistical Manual of Mental Disorders; Dietary Fiber; Diterpenes; DNA Methylation; Dogs; Double-Blind Method; Drug Design; Drug Resistance, Bacterial; Drug Resistance, Multiple, Bacterial; Drug Screening Assays, Antitumor; Eicosapentaenoic Acid; Enzyme-Linked Immunosorbent Assay; Epidermis; Escherichia coli; Escherichia coli Infections; Extraintestinal Pathogenic Escherichia coli; Fatty Acids; Fatty Acids, Unsaturated; Fatty Acids, Volatile; Feasibility Studies; Feces; Female; Ferritins; Fluorodeoxyglucose F18; Gastrectomy; Gastrointestinal Microbiome; Gemcitabine; Glomerular Filtration Rate; Glucose; Glycerol; Granulocyte-Macrophage Colony-Stimulating Factor; HeLa Cells; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Hypoxia-Inducible Factor-Proline Dioxygenases; Immunoassay; Immunoglobulin G; India; Infant, Newborn; Infertility; Inflammation; Intensive Care Units; Iron; Iron Deficiencies; Kidney; Lacticaseibacillus rhamnosus; Laurencia; Leukocytes; Lipids; Liver Cirrhosis; Long Interspersed Nucleotide Elements; Longitudinal Studies; Male; Mesenchymal Stem Cells; Methicillin-Resistant Staphylococcus aureus; Mice; Microalgae; Microbial Sensitivity Tests; Microscopy; Middle Aged; Minerals; Molecular Conformation; Molecular Docking Simulation; Molecular Structure; Mycobacterium tuberculosis; Myeloid Cells; Myeloid-Derived Suppressor Cells; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Nephropidae; Nicotinic Antagonists; Nitrogen; Obesity; Oxaliplatin; Paclitaxel; Panax; Pancreatic Neoplasms; Pancreatitis; Personality; Personality Disorders; Personality Inventory; Photobioreactors; Plant Extracts; Plasmalogens; Plasmids; Polymorphism, Genetic; Polynesia; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Prebiotics; Predictive Value of Tests; Prognosis; Prolyl-Hydroxylase Inhibitors; Rabbits; Radiopharmaceuticals; Rats; Rats, Wistar; Receptors, Nicotinic; Recombinant Proteins; Retrospective Studies; Rifampin; Risk Factors; RNA, Ribosomal, 16S; Salinity; Seaweed; Sensitivity and Specificity; Sepsis; Sesquiterpenes; Severity of Illness Index; Shock, Septic; Silicones; Single Photon Emission Computed Tomography Computed Tomography; Skin; Snails; Solubility; Solvents; Sputum; Staphylococcal Infections; Stomach Neoplasms; Stramenopiles; Structure-Activity Relationship; Technetium Tc 99m Exametazime; Technology; Terpenes; Tuberculosis; Tuberculosis, Multidrug-Resistant; Urinary Catheters; Urinary Tract Infections; Vascular Endothelial Growth Factor A; Virulence Factors; Water; Wound Healing

A 47-year-old man diagnosed with pulmonary tuberculosis was referred to our hospital. Rifampicin, isoniazid, pyrazinamide and ethambutol were administered, and the patient's symptoms promptly improved. On the 19th hospital day, he developed acute kidney injury with a fever and chills. Renal biopsy specimens indicated tubulointerstitial nephritis. Suspecting rifampicin-induced acute kidney injury, we discontinued the rifampicin and administered levofloxacin in its place. The patient's serum creatinine level subsequently gradually improved. We herein report this case and review eight cases reported in Japan. We found that the rifampicin toxicity appeared at both the initial administration and readministration. All eight patients presented with proteinuria.

Topics: Acute Kidney Injury; Antitubercular Agents; Creatinine; Drug Therapy, Combination; Humans; Japan; Male; Middle Aged; Nephritis, Interstitial; Rifampin; Tuberculosis, Pulmonary

A 71-year-old woman was treated for a relapsing pulmonary tuberculosis with reinstitution of rifampicin after a medication-free interval of 2 years. After ingestion of the second dose, she developed severe hemolytic anemia and acute renal failure (ARF) necessitating dialysis. We demonstrated the presence in the patient's serum of rifampicin-dependent immunoglobulin G (IgG) and IgM antibodies, which caused red blood cell lysis through interaction with the I antigen on the erythrocyte surface. A review of the literature yielded 48 cases of rifampicin-associated renal failure. A subgroup of 37 patients could be distinguished, which, analogous to our case, suddenly developed ARF and frequently also developed hemolytic anemia and/or thrombocytopenia during intermittent or interrupted treatment. Regarding the pathogenesis of the ARF, renal biopsy consistently revealed tubular lesions. Although intravascular hemolysis with hemoglobinuria may play a role, it is not uniformly present. Our demonstration of an antibody with anti-I specificity provides a possible explanation. The I antigen is also expressed on tubular epithelium and may, therefore, be the target structure through which rifampicin-antibody complexes lead to tubular cell destruction. The other cases of rifampicin-associated ARF were unrelated to this subgroup: two cases of rapidly progressive glomerulonephritis, five cases of acute interstitial nephritis, and four cases of light chain proteinuria were recorded.

Topics: Acute Kidney Injury; Aged; Anemia, Hemolytic; Antibiotics, Antitubercular; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Rifampin; Time Factors; Tuberculosis, Pulmonary

A case of a 73-year-old woman with acute renal failure due to toxic shock syndrome (TSS) is reported. The patient was admitted to our hospital with the complaints of high fever, disturbance of consciousness and shock. Laboratory findings on admission were; CRP 25.11 mg/dl, WBC 35000/ microl, Plt 1.6 x 10(4)/ microl, GOT 155 U/l, GPT 65 U/l, CPK 4202 U/l (CPK-MM 96%), BUN 123 mg/dl and SCr 7.0 mg/dl. Because of anuria, hemodialysis was performed. This patient was treated with dopamine, methyl prednisolone (MP), frozen fresh plasma, AT III, antibiotics, and platelet transfusion. The bacterial cultures of blood and cerebrospinal fluid were negative, but MRSA was isolated subsequently from the pharynx and vagina. We investigated the production of toxic shock syndrome toxin 1 (TSST-1) and staphylococcal enterotoxins (SE). The isolated MRSA produced TSST-1, SEB and SEC. Accordingly, we made the diagnosis of TSS. After improvement of acute renal failure and the patient's general condition, MRSA persisted and TSST-1 was still found in the patient's blood. Finally we eradicated the MRSA and TSST-1 after administration of ciprofloxacin hydrochloride (CPFX) and Rifampicin (RFP).

Topics: Acute Kidney Injury; Aged; Anti-Infective Agents; Antibiotics, Antitubercular; Bacterial Toxins; Ciprofloxacin; Disseminated Intravascular Coagulation; Enterotoxins; Female; Humans; Methicillin Resistance; Rifampin; Shock, Septic; Staphylococcal Infections; Staphylococcus aureus; Superantigens

A case is reported of hemolytic anemia following rifampicin administration and complicated by acute renal failure. Furthermore clotting analyses suggested a slight disseminated intravascular coagulation, very likely activated by hemolysis products. Both hemolysis and renal function impairment subsided spontaneously, after the sole withdrawal of rifampin. Direct antiglobulin test became negative within a few days, while an indirect Coomb's test was demonstrated persistently with the patient's serum using red blood cells sensitized in vitro with the drug. Otherwise from all reports in the literature, the patient developed an acute hemolytic anemia while on daily therapy and as many as twenty years after a previous treatment with rifampicin. Mechanisms of drug-induced immune hemolytic anemia and acute nephropathy are discussed (formation of drug-antibody complexes, which adhere on the red blood cells surface and are able to fix complement and induce intravascular hemolysis; tubular necrosis due to hemoglobinuria or immuno-mediated interstitial nephritis).

Topics: Acute Kidney Injury; Anemia, Hemolytic, Autoimmune; Bronchitis; Chronic Disease; Drug Therapy, Combination; Female; Humans; Middle Aged; Rifampin; Time Factors

(1) AIN is the most frequent pattern of drug-induced immunologically mediated renal injury. A number of drugs may be responsible for AIN, namely methicillin and other penicillin derivatives, rifampicin, phenindione and sulfonamides. Particular clinical and pathological features often suggest an immune pathogenetic mechanism. IgG anti-TBM and IgE antibodies have been found in only a few cases and it is likely that antibody-mediated and cell-mediated injury may operate in the same patient. (2) Only few examples of drug-induced vasculitis and glomerulonephritis are known, and the pathophysiology of this kind of renal damage is poorly understood.

Topics: Acute Kidney Injury; Antigens; Basement Membrane; Drug Hypersensitivity; Glafenine; Glomerulonephritis; Humans; Kidney; Kidney Glomerulus; Kidney Tubules; Methicillin; Nephritis, Interstitial; Penicillin G; Penicillins; Phenindione; Rifampin; Sulfonamides; Vasculitis

Topics: Acute Kidney Injury; Anemia, Hemolytic; Digestive System; Humans; Influenza, Human; Liver; Rifampin; Skin; Syndrome; Thrombocytopenia; Tuberculosis, Pulmonary

A new case of acute renal failure after rifampicin is presented, together with a review of the 36 similar cases published up to date in the literature. Evidence is provided that irregularities in drug intake, either as true intermittent treatment or as discontinuation of continuous therapy, play an important role in the pathogenesis of such reactions. Renal failure appeared after a rather long uneventful interval from the beginning of rifampicin therapy, ranging from 1 month to more than 1 year. Its clinical course was favourable in all but one case; the histological picture was mainly of tubulo-interstitial type. The controversial immunological data reported in the literature are reviewed; an increase of histamine release by rat mast cells has been found in presence of rifampicin plus the serum of our patient: the implications of this finding are discussed, suggesting a possible immunological factor in the pathogenesis of acute renal failure after rifampicin.

Topics: Acute Kidney Injury; Adult; Drug Administration Schedule; Drug Hypersensitivity; Humans; Male; Rifampin

Topics: Acute Kidney Injury; Anaphylaxis; Anemia, Hemolytic; Dose-Response Relationship, Drug; Drug Hypersensitivity; Humans; Hypotension; Purpura, Thrombocytopenic; Rifampin

To develop the 'Stronger Towns Index': a deprivation index that took into account characteristics of areas encompassing towns that may be eligible for redevelopment funding and explore how this index was associated with self-rated health and migration within England between 2001 and 2011.. There were areas in the lowest deciles of Town Strength who did not receive funding. After multiple adjustment, LS members living in areas with higher deciles were significantly more likely (7% to 38%) to report good health than those in the lowest decile in 2001. Remaining in the same decile between 2001 and 2011 was associated with 7% lower odds of good self-rated health in 2011.. It is important to consider health in towns when allocating funding. Areas in the Midlands may have missed out on funding which might help mitigate poor health.. Ferritin levels <30µg/L were associated with unexplained infertility and might be screened in the future. Further studies with a focus on iron deficiency and iron treatment on women with unexplained infertility are warranted.. This EGM provides a valuable resource for researchers, policy-makers and the public to access the available evidence on the determinants of various COVID-19 health-related behaviours. The map can also be used to help guide research commissioning, by evidence synthesis teams and evidence intermediaries to inform policy during the ongoing pandemic and potential future outbreaks of COVID-19 or other respiratory infections. Evidence included in the map will be explored further through a series of systematic reviews examining the strength of the associations between malleable determinants and the uptake and maintenance of individual protective behaviours.. Patients with polymicrobial bloodstream infections are typically critically ill and harbor multidrug-resistant bacteria. Thus, to minimize mortality rate in critically ill patients, changes in infectious flora should be monitored, antibiotics selected reasonably, and invasive procedures reduced.. Altogether, these findings clearly revealed the great potential of the in vitro biological activity of linseed extract as a safe source for combatting multidrug-resistant. In this work, the capture of carbon dioxide using a dense hollow fiber membrane was studied experimentally and theoretically. The factors affecting the flux and recovery of carbon dioxide were studied using a lab-scale system. Experiments were conducted using a mixture of methane and carbon dioxide to simulate natural gas. The effect of changing the CO. Persistent gender and racial disparities in high-impact medical and critical care journals underscore the need to revise policies and strategies to encourage greater diversity in critical care research.. Thirty evaluable patients were enrolled. Median age was 60.5 years. Median follow-up for all patients was 17 months. Ten patients (33%) experienced grade ≥ 3 treatment-related adverse events, the most common being neutropenia and diarrhea; 50% required ≥ 1 dose reduction. The disease control rate was 90% (progressive disease: 10%, partial response: 23%, stable disease: 67%). There was zero treatment-related mortality. Twenty-two patients (73%, 90% CI 57-86; p = 0.008) completed all chemotherapy and surgery. Two patients (9%) who successfully underwent resection had minor postoperative complications. Median length of hospital stay was 4 days. Median RFS was 7.1 months. Median OS for the entire cohort was 24 months and was not reached in patients who underwent surgical resection.. Neoadjuvant treatment with gemcitabine, cisplatin, and nab-paclitaxel is feasible and safe prior to resection of intrahepatic cholangiocarcinoma and does not adversely impact perioperative outcomes.

Topics: Acetogenins; Acute Disease; Acute Kidney Injury; Administration, Intravenous; Aged; Albumins; Alcoholism; Aldehyde Dehydrogenase; Aldehyde Dehydrogenase, Mitochondrial; alpha-Glucosidases; Anemia; Animals; Anthozoa; Anti-Bacterial Agents; Anti-Infective Agents; Antibodies, Bacterial; Antigens, Bacterial; Antihypertensive Agents; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Antioxidants; Apoptosis; Ascites; Asthma; Bacteria; beta-Lactamases; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Binding Sites; Biological Availability; Biomass; Borderline Personality Disorder; Brain; Brucella abortus; Brucella melitensis; Brucellosis; Calcium; Carbapenems; Case-Control Studies; Caseins; Cattle; CD8-Positive T-Lymphocytes; Ceftaroline; Cell Line; Cell Line, Tumor; Cell Physiological Phenomena; Cell Proliferation; Cephalosporins; Chemotherapy, Adjuvant; China; Chitin; Chlorella; Chlorophyll; Chlorophyll A; Chlorophyta; Cholangiocarcinoma; Cisplatin; Conotoxins; Contrast Media; Conus Snail; Cross-Sectional Studies; Cytokines; Decapodiformes; Deoxycytidine; Diagnostic and Statistical Manual of Mental Disorders; Dietary Fiber; Diterpenes; DNA Methylation; Dogs; Double-Blind Method; Drug Design; Drug Resistance, Bacterial; Drug Resistance, Multiple, Bacterial; Drug Screening Assays, Antitumor; Eicosapentaenoic Acid; Enzyme-Linked Immunosorbent Assay; Epidermis; Escherichia coli; Escherichia coli Infections; Extraintestinal Pathogenic Escherichia coli; Fatty Acids; Fatty Acids, Unsaturated; Fatty Acids, Volatile; Feasibility Studies; Feces; Female; Ferritins; Fluorodeoxyglucose F18; Gastrectomy; Gastrointestinal Microbiome; Gemcitabine; Glomerular Filtration Rate; Glucose; Glycerol; Granulocyte-Macrophage Colony-Stimulating Factor; HeLa Cells; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Hypoxia-Inducible Factor-Proline Dioxygenases; Immunoassay; Immunoglobulin G; India; Infant, Newborn; Infertility; Inflammation; Intensive Care Units; Iron; Iron Deficiencies; Kidney; Lacticaseibacillus rhamnosus; Laurencia; Leukocytes; Lipids; Liver Cirrhosis; Long Interspersed Nucleotide Elements; Longitudinal Studies; Male; Mesenchymal Stem Cells; Methicillin-Resistant Staphylococcus aureus; Mice; Microalgae; Microbial Sensitivity Tests; Microscopy; Middle Aged; Minerals; Molecular Conformation; Molecular Docking Simulation; Molecular Structure; Mycobacterium tuberculosis; Myeloid Cells; Myeloid-Derived Suppressor Cells; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Nephropidae; Nicotinic Antagonists; Nitrogen; Obesity; Oxaliplatin; Paclitaxel; Panax; Pancreatic Neoplasms; Pancreatitis; Personality; Personality Disorders; Personality Inventory; Photobioreactors; Plant Extracts; Plasmalogens; Plasmids; Polymorphism, Genetic; Polynesia; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Prebiotics; Predictive Value of Tests; Prognosis; Prolyl-Hydroxylase Inhibitors; Rabbits; Radiopharmaceuticals; Rats; Rats, Wistar; Receptors, Nicotinic; Recombinant Proteins; Retrospective Studies; Rifampin; Risk Factors; RNA, Ribosomal, 16S; Salinity; Seaweed; Sensitivity and Specificity; Sepsis; Sesquiterpenes; Severity of Illness Index; Shock, Septic; Silicones; Single Photon Emission Computed Tomography Computed Tomography; Skin; Snails; Solubility; Solvents; Sputum; Staphylococcal Infections; Stomach Neoplasms; Stramenopiles; Structure-Activity Relationship; Technetium Tc 99m Exametazime; Technology; Terpenes; Tuberculosis; Tuberculosis, Multidrug-Resistant; Urinary Catheters; Urinary Tract Infections; Vascular Endothelial Growth Factor A; Virulence Factors; Water; Wound Healing

The study aimed to prospectively assess incidence and risk factors for colistin-associated nephrotoxicity. This is a secondary analysis of a multicentre, randomized clinical trial, comparing efficacy and safety of colistin versus the combination of colistin plus rifampicin in severe infections due to extensively drug-resistant (XDR) Acinetobacter baumannii. The primary end point was acute kidney injury (AKI) during colistin treatment, assessed using the AKI Network Criteria, and considering death as a competing risk. A total of 166 adult patients without baseline kidney disease on renal replacement therapy were studied. All had life-threatening infections due to colistin-susceptible XDR A. baumannii. Patients received colistin intravenously at the same initial dose (2 million international units (MIU) every 8 h) with predefined dose adjustments according to the actual renal function. Serum creatinine was measured at baseline and at days 4, 7, 11, 14 and 21 (or last day of therapy when discontinued earlier). Outcomes assessed were 'time to any kidney injury' (AKI stages 1-3) and 'time to severe kidney injury' (considering only AKI stages 2-3 as events). When evaluating overall mortality, AKI occurrence was modelled as a time-dependent variable. AKI was observed in 84 patients (50.6%, stage 1 in 40.4%), with an incidence rate of 5/100 person-days (95% CI 4-6.2). Risk estimates of AKI at 7 and 14 days were 30.6% and 58.8%. Age and previous chronic kidney disease were significantly associated with any AKI in multivariable analysis. Neither 'any' nor 'severe AKI' were associated with on-treatment mortality (p 0.32 and p 0.54, respectively). AKI occurs in one-third to one-half of colistin-treated patients and is more likely in elderly patients and in patients with kidney disease. As no impact of colistin-associated AKI on mortality was found, this adverse event should not represent a reason for withholding colistin therapy, whenever indicated.

Topics: Acinetobacter baumannii; Acinetobacter Infections; Acute Kidney Injury; Adult; Aged; Anti-Bacterial Agents; Colistin; Creatinine; Dose-Response Relationship, Drug; Drug Resistance, Multiple, Bacterial; Endpoint Determination; Female; Humans; Incidence; Male; Middle Aged; Multivariate Analysis; Prospective Studies; Rifampin; Risk Assessment

To determine the efficacy of minocycline-rifampin-coated hemodialysis catheters in reducing catheter-related infections in patients requiring hemodialysis for acute renal failure.. Between May 2000 and March 2002, 66 patients were randomly assigned to receive a minocycline-rifampin-impregnated central venous catheter and 64 were randomly assigned to receive an unimpregnated catheter. Patients were followed prospectively until the catheter was removed. Catheter-related infection was determined through quantitative catheter cultures, quantitative blood cultures, or both.. Both groups of patients were similar in age, sex, underlying disease, type of dialysis (continuous vs. intermittent), neutropenia during catheterization and its duration, catheter insertion difficulties, and administration of blood products or medication. The mean (+/- SD) catheter dwell time was the same in both groups (8 +/- 6 days, P = 0.7). There were seven catheter-related infections (11%), all associated with the use of unimpregnated catheters. Kaplan-Meier estimates for the risk of catheter-related infection showed that coated catheters were less likely to be associated with infection (P = 0.006).. The use of polyurethane hemodialysis catheters impregnated with minocycline and rifampin decreases the risk of catheter-related infection in patients with acute renal failure.

Topics: Acute Kidney Injury; Anti-Bacterial Agents; Antibiotics, Antitubercular; Catheterization, Central Venous; Drug Therapy, Combination; Female; Humans; Male; Methicillin Resistance; Middle Aged; Minocycline; Polyurethanes; Prospective Studies; Renal Dialysis; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Staphylococcus epidermidis; Time Factors

Today, kidney diseases are increasing day by day and life quality is decreasing. In hospitalized patients of all ages, acute kidney injury (AKI) is commonly observed and associated with high rates of morbidity and mortality. Rifampicin (RF) or rifampin is an antibiotic drug from the rifamycin group with a bactericidal effect. RF causes acute kidney injury, often anemia, thrombocytopenia, liver damage and side effect such as cell death. RF causes tissue damage by means of oxidative stress and apoptosis. Thus, in this study, it was examined whether linalool (LN) which had antinociceptive, antimicrobial, antioxidant and anti-inflammatory effects, was beneficial for kidney damage in order to eliminate the side effects of RF. NGAL mRNA, creatinine (Cr), blood urea nitrogen (BUN), Caspase 9 (CAS-9) and nuclear factor-κB (NF-κB) levels increased in the group treated with RF compared to the control group, while the levels of albumin, uric acid and total protein were decreased in the RF-treated group. NGAL mRNA, BUN, Cr, CAS-9 and NF-κB levels decreased significantly in RF+LN administered rats, while it was observed that there was an increase in the levels of albumin, uric acid and total protein. From the results obtained, it was observed that LN was determined to be very effective in preventing tissue damage in kidneys caused by oxidative stress by RF.

Topics: Acute Kidney Injury; Animals; Apoptosis; Kidney; Lipocalin-2; NF-kappa B; Oxidative Stress; Rats; Rifampin; RNA, Messenger; Signal Transduction; Uric Acid

Topics: Acute Kidney Injury; Administration, Intravesical; Aged; Antitubercular Agents; BCG Vaccine; Ethambutol; Humans; Isoniazid; Kidney; Male; Nephritis; Renal Insufficiency, Chronic; Rifampin; Treatment Outcome; Urinary Bladder Neoplasms

Infective endocarditis is associated with a variety of clinical signs, but its association with multisystem vasculitis is rarely reported. A high index of suspicion is necessary to differentiate a primary autoimmune vasculitis from an infectious cause as the wrong treatment can lead to significant morbidity and mortality. We present a 71-year-old female patient with negative blood cultures, on antibiotics for recent bacteraemia, who presented with cutaneous and renal leucocytoclastic vasculitis. Workup revealed a vegetation adjacent to her right atrial pacemaker lead consistent with infective endocarditis and her vasculitis completely resolved with appropriate antibiotics.

Topics: Acute Kidney Injury; Aged; Anti-Bacterial Agents; Antibodies, Antineutrophil Cytoplasmic; Bacteremia; Ceftriaxone; Endocarditis, Bacterial; Female; Humans; Pulmonary Edema; Renal Dialysis; Respiratory Insufficiency; Rifampin; Skin Diseases, Vascular; Staphylococcal Infections; Vasculitis

Objective The standard anti-tuberculosis (TB) regimen occasionally causes acute kidney injury (AKI). The major etiology is rifampicin-induced acute interstitial nephritis. However, the standard management of AKI induced by anti-TB drugs has yet to be established. Methods We retrospectively reviewed patients with TB who developed AKI after starting standard anti-TB treatment between 2006 and 2016 at a single TB center. The clinical characteristics and the management are described. Results Among 1,430 patients with active TB, 15 (1.01%) developed AKI. The mean age (standard deviation) was 61 years (18). The median (interquartile range) time to AKI development was 45 days (21-54 days). The median serum creatinine level before anti-TB treatment was 0.7 mg/dL (0.5-1.4 mg/dL), whereas the median peak serum creatinine level after AKI onset was 4.0 mg/dL (3.08-5.12 mg/dL). Five patients (33.3%) were pathologically confirmed as having acute interstitial nephritis (AIN), and 7 patients (46.7%) had a clinical diagnosis of the disease. All anti-TB drugs were stopped, and steroids were administered to 5 (100%) patients with pathologically confirmed AIN and 3 (42.8%) patients with clinically diagnosed AIN. The renal function was normalized in 12 patients (80.0%) after restarting anti-TB treatment without rifampicin (n=12) or isoniazid (n=1). Two patients died due to severe renal failure after restarting rifampicin. Conclusion Rifampicin is the leading cause of AKI. Levofloxacin may be an alternative to rifampicin thanks to its safety and potency. Restarting anti-TB treatment without rifampicin and short-term steroid administration may be a feasible management for AKI.

Topics: Acute Kidney Injury; Adult; Aged; Aged, 80 and over; Antitubercular Agents; Female; Humans; Japan; Male; Middle Aged; Nephritis, Interstitial; Retrospective Studies; Rifampin; Tuberculosis

We present a case of pulmonary tuberculosis treated with a rifampicin (RMP) containing regimen, which led to marked haemolysis and acute kidney injury. The patient was shown to have RMP-induced haemolysis on detailed immunological testing. RMP is described as a rare cause of drug-induced haemolysis in the literature. However, it is a widely used drug and this complication may be severe. RMP-induced haemolysis precludes further treatment with the drug. Clinicians should consider this possibility and seek advice if patients on RMP develop haemolysis.

Topics: Acute Kidney Injury; Adolescent; Antitubercular Agents; Hemolysis; Humans; Male; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Antitubercular Agents; Humans; Rifampin

The standard drugs used to treat tuberculosis are rifampicin and isoniazid. These agents are usually safe and inexpensive for short-term use in treatment of latent tuberculosis infection, but sometimes cause adverse renal effects, including minimal change disease (MCD).. Here, we report a 51-year-old woman with latent tuberculosis infection who developed nephrotic syndrome during treatment with rifampicin and isoniazid for 25 days.. Renal biopsy findings were compatible with MCD, and she had no relevant medical history and was not taking other medications. A diagnosis of anti-tuberculosis drug- induced MCD was made. This is the first report of acute renal failure due to rifampicin and/or isoniazid-induced MCD.. After cessation of rifampicin and isoniazid, however, acute renal failure progressed and she was treated with temporary dialysis and oral prednisolone.. The patient achieved complete remission after cessation of rifampicin and isoniazid with steroid therapy.. This case demonstrates that rifampicin and/or isoniazid can cause nephrotic syndrome with acute renal failure during the first months of continuous latent tuberculosis therapy. Therefore, renal function and proteinuria should be monitored carefully in all patients taking rifampicin and isoniazid, especially during the first few months of therapy.

Topics: Acute Kidney Injury; Antitubercular Agents; Female; Glucocorticoids; Humans; Isoniazid; Latent Tuberculosis; Middle Aged; Nephrosis, Lipoid; Nephrotic Syndrome; Prednisolone; Proteinuria; Remission Induction; Renal Dialysis; Rifampin; Treatment Outcome

Treatment for latent tuberculous infection (LTBI) is a key strategy for the elimination of tuberculosis. Rare adverse reactions associated with LTBI treatment have been reported. We report the only case of acute kidney injury reported to Centers for Disease Control and Prevention surveillance for LTBI treatment-related adverse events. The patient experienced rapid intravascular hemolysis, resulting in heme pigment nephropathy; he was hospitalized and received three hemodialysis treatments, but recovered without sequelae. While LTBI treatment-related adverse events are rare, health care providers should maintain clinical vigilance and regularly counsel patients to facilitate prompt diagnoses and effective clinical management of affected patients.

Topics: Acute Kidney Injury; Adult; Antibiotics, Antitubercular; Humans; Latent Tuberculosis; Male; Renal Dialysis; Rifampin

Nephrotoxicity is a rare complication caused by anti-tuberculosis therapy-induced oxidative stress. The Cyanobacterium Spirulina fusiformis Voronikhin belonging to Oscillatoriaceae family is used traditionally as a source of antioxidants against oxidative stress. We aimed to investigate the efficacy of S. fusiformis in modifying isoniazid (INH) and rifampicin (RIF)-induced changes in Wistar rat kidneys. Animals were divided into six groups: normal control rats; toxic control (INH & RIF-50 mg/kg b.w./d each; p.o.); INH & RIF + S. fusiformis (400 mg/kg b.w./d); INH & RIF + S. fusiformis (800 mg/kg b.w./d); S. fusiformis (800 mg/kg b.w./d) alone-treated rats; INH & RIF + silymarin (25 mg/kg b.w./d). Study duration was 28 d after which blood and kidneys were analyzed. We also studied the binding and interactions of the transcription factors Liver X Receptor (LXR) and Farnesoid X Receptor (FXR) with INH, RIF, and representative active compounds of S. fusiformis by in silico methods. INH & RIF treatment caused significant (p< 0.05) decrease in antioxidant levels and significant (p< 0.05) increase in the levels of creatinine, urea, and uric acid showing impaired kidney function. Spirulina fusiformis ameliorated these effects in a dose dependent manner. Histological examination of kidneys supported these findings. Results of the in silico analyses showed that selected active components of S. fusiformis interact with LXR and FXR and could be a possible mechanism of action. S. fusiformis rendered protection against anti-tuberculosis drugs-induced oxidative stress in kidney tissues of rats.

Topics: Acute Kidney Injury; Animals; Antioxidants; Antitubercular Agents; Creatinine; Disease Models, Animal; Female; Humans; Isoniazid; Kidney; Lipid Peroxidation; Liver; Oxidative Stress; Protective Agents; Rats; Rats, Wistar; Receptors, Cytoplasmic and Nuclear; Rifampin; Silymarin; Spirulina; Urea; Uric Acid

We present the case of a 68-year-old man admitted to hospital with severe acute kidney injury secondary to statin-induced rhabdomyolysis. Five weeks previously, the patient started a course of clarithromycin for infection of a finger wound with Mycobacterium marinum. His current medications included simvastatin, which he continued along with clarithromycin. The severity of the acute kidney injury necessitated initial continuous venovenous haemofiltration followed by 12 haemodialysis sessions before a spontaneous improvement in renal function occurred. Statins are widely prescribed and we report this case to encourage increased vigilance in avoiding drug interactions known to increase the risk of statin-induced myopathy, including macrolide antibiotics, calcium channel antagonists and amiodarone. The authors would also like to highlight recent guidance on atorvastatin as the statin of choice in patients with chronic kidney disease, and of the need for dose adjustment in those with an estimated glomerular filtration rate less than 30 mLs/min/1.73 m².

Topics: Acute Kidney Injury; Aged; Anti-Bacterial Agents; Clarithromycin; Drug Interactions; Ethambutol; Finger Injuries; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Mycobacterium Infections, Nontuberculous; Renal Dialysis; Rhabdomyolysis; Rifampin; Simvastatin

Prolonged antimicrobial therapy is recommended for methicillin-susceptible Staphylococcus aureus (MSSA) bone and joint infections (BJI), but its safety profile and risk factors for severe adverse events (SAE) in clinical practice are unknown. We addressed these issues in a retrospective cohort study (2001 to 2011) analyzing antimicrobial-related SAE (defined according to the Common Terminology Criteria for Adverse Events) in 200 patients (male, 62%; median age, 60.8 years [interquartile range {IQR}, 45.5 to 74.2 years]) with MSSA BJI admitted to a reference regional center with acute (66%) or chronic arthritis (7.5%), osteomyelitis (9.5%), spondylodiscitis (16%), or orthopedic device-related infections (67%). These patients received antistaphylococcal therapy for a median of 26.6 weeks (IQR, 16.8 to 37.8 weeks). Thirty-eight SAE occurred in 30 patients (15%), with a median time delay of 34 days (IQR, 14.75 to 60.5 days), including 10 patients with hematologic reactions, 9 with cutaneomucosal reactions, 6 with acute renal injuries, 4 with hypokalemia, and 4 with cholestatic hepatitis. The most frequently implicated antimicrobials were antistaphylococcal penicillins (ASP) (13 SAE/145 patients), fluoroquinolones (12 SAE/187 patients), glycopeptides (9 SAE/101 patients), and rifampin (7 SAE/107 patients). Kaplan-Meier curves and stepwise binary logistic regression analyses were used to determine the risk factors for the occurrence of antimicrobial-related SAE. Age (odds ratio [OR], 1.479 for 10-year increase; 95% confidence interval [CI], 1.116 to 1.960; P = 0.006) appeared to be the only independent risk factor for SAE. In patients receiving ASP or rifampin, daily dose (OR, 1.028; 95% CI, 1.006 to 1.051; P = 0.014) and obesity (OR, 8.991; 95% CI, 1.453 to 55.627; P = 0.018) were associated with the occurrence of SAE. The high rate of SAE and their determinants highlighted the importance of the management and follow-up of BJI, with particular attention to be paid to older persons, especially for ASP dosage, and to rifampin dose adjustment in obese patients.

Topics: Acute Kidney Injury; Aged; Anti-Bacterial Agents; Arthritis, Infectious; Bone and Bones; Discitis; Female; Fluoroquinolones; Humans; Hypokalemia; Inflammation; Jaundice, Obstructive; Joints; Male; Middle Aged; Osteomyelitis; Penicillins; Prosthesis-Related Infections; Retrospective Studies; Rifampin; Risk Factors; Staphylococcal Infections; Staphylococcus aureus

Phenytoin, a commonly used antiepileptic, is difficult to dose optimally due to its narrow therapeutic window, nonlinear pharmacokinetics, extensive protein binding, and participation in clinically significant drug interactions. Although clinicians are aware of the interaction with two widely used antituberculosis agents, rifampin and isoniazid, few reports have described the implications for managing phenytoin dosing in this situation. To our knowledge, only two reports of the clinical experience with this interaction have been published, and only one of these reports involved the addition of isoniazid. We present a case of a 60-year-old man treated with triple antiepileptic therapy, including phenytoin, who experienced seizures shortly after hospital admission. Dosing of phenytoin proved difficult in this patient due to an acute kidney injury and severe hypoalbuminemia requiring hemodialysis. A further complexity was the addition of antituberculosis therapy (rifampin, isoniazid, pyrazinamide, and ethambutol [RIPE]) for suspected tuberculosis meningitis after the patient experienced persistent encephalopathy. Phenytoin concentrations decreased steadily after rifampin and isoniazid initiation despite dose increases, and the free concentration of phenytoin reached a low of less than 0.5 µg/ml on day 8 of RIPE therapy. The patient continued on a stable dose of phenytoin and RIPE therapy for unconfirmed tuberculosis meningitis until discharge. This report is the first description of this drug interaction in 20 years and highlights the need for appropriate management of phenytoin in a patient with complicated needs for pharmacotherapy.

Topics: Acute Kidney Injury; Anticonvulsants; Antitubercular Agents; Dose-Response Relationship, Drug; Drug Interactions; Humans; Hypoalbuminemia; Male; Middle Aged; Phenytoin; Renal Dialysis; Rifampin; Seizures; Severity of Illness Index; Tuberculosis, Meningeal

Rifampicin is a widely used anti-tuberculosis agent. Apart from hepatotoxicity, rifampicin can rarely lead to adverse reactions of immunologic nature such as acute renal failure (ARF). We report the case of 57-year-old previously healthy man under treatment for pulmonary tuberculosis who presented with hemolysis and severe ARF. Rifampicin was discontinued and the patient was treated with fluid repletion, iv furosemide and dialysis therapy. Kidney biopsy revealed acute tubulointerstitial nephritis with no evidence of granulomas. The patient significantly improved and was discharged after 51 days of hospitalization. Clinicians using rifampicin should be aware of this rather uncommon but severe complication.

Topics: Acute Kidney Injury; Antibiotics, Antitubercular; Hemolysis; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Antitubercular Agents; Disseminated Intravascular Coagulation; Drug Therapy, Combination; Female; Humans; Renal Dialysis; Rifampin; Tuberculosis, Pulmonary; Young Adult

We present the case of a 42-year-old male patient who applied to the emergency department of our hospital with clinical nephritis, orchitis, acute renal failure without endocarditis, and a low-grade fever. Brucella agglutinin titers were 1:160, Rose Bengal test was positive and Brucella melitensis was isolated from urine and blood cultures.. A combination of oral rifampin (600 mg/day) and doxycycline (200 mg/day) was administered along with supportive treatment leading to resolution of his clinical status by eight weeks. This was a rare complication of severe renal involvement due to brucellosis which resolved with antibiotic treatment.

Topics: Acute Kidney Injury; Adult; Anti-Bacterial Agents; Blood; Brucella melitensis; Brucellosis; Doxycycline; Humans; Male; Rifampin; Urine

Topics: Acute Kidney Injury; Anemia, Hemolytic, Autoimmune; Antitubercular Agents; Diagnosis, Differential; Drug Therapy, Combination; Humans; Male; Middle Aged; Nephritis, Interstitial; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Aged; Humans; Male; Rifampin; Thrombocytopenia; Vasculitis, Leukocytoclastic, Cutaneous

Topics: Acute Kidney Injury; Adult; Anaphylaxis; Anemia, Hemolytic; Antibiotics, Antitubercular; Disseminated Intravascular Coagulation; Drug Hypersensitivity; Humans; Hypersensitivity, Immediate; Liver; Male; Renal Dialysis; Rifampin; Treatment Outcome; Tuberculosis, Pulmonary

Dapsone syndrome is a rare hypersensitivity reaction to dapsone and is characterized by high fever, papular or exfoliative dermatitis, progressing to liver toxicity and generalized lymphadenopathy, resembling a mononucleosis infection. We report a patient who developed acute renal failure, as well as other complications characteristic of dapsone syndrome, during leprosy treatment. Renal involvement had not been previously described as a dapsone syndrome feature.

Topics: Acute Kidney Injury; Adult; Clofazimine; Dapsone; Drug Hypersensitivity; Drug Therapy, Combination; Female; Humans; Leprostatic Agents; Leprosy; Rifampin; Syndrome

Rifampicin is a crucial component of treatment regimens for tuberculosis and has been in use since the early 1970's. It is usually considered safe. Rarely life-threatening complications like acute renal failure or acute thrombocytopaenia may manifest during treatment with rifampicin. In our experience at the Tuberculosis Research Centre of treating more than 8000 pulmonary and extrapulmonary tuberculosis patients with rifampicin-containing regimens over the last 30 years, we are reporting 3 cases of probably rifampicin-induced acute renal failure. Despite extreme therapeutic safety of this drug the clinician must be aware of this rare complication, which if detected early is completely reversible.

Topics: Acute Kidney Injury; Adolescent; Adult; Antibiotics, Antitubercular; Humans; Male; Rifampin; Tuberculosis, Pulmonary

Rifampicin re-administration may cause immunologically mediated acute tubulo-interstitial injury. Retrospectively, 170 consecutive cases with acute renal failure (ARF) following re-treatment with rifampicin (71% males, 29% females, age 21 to 68 years) were analysed, which accounted for 12% of all ARF patients treated by two large dialysis referral centres in Romania, Timisoara and Iasi, between 1974-2001 and 1988-2001, respectively. The most frequent clinical features of rifampicin-induced ARF were: Anuria, gastro-intestinal (abdominal pain, nausea, vomiting and diarrhoea) and "flu-like" symptoms. Urine analysis revealed sterile leucocyturia in 54%, proteinuria in 31%, haematuria in 26% and haemoglobinuria in 7% of cases. Haemolytic anaemia was frequent, found in 66% of the patients; half of these had Hct values of < 30%, thrombocytopenia and also more severe renal damage (a longer anuric phase and a slower recovery of the renal function), thus suggesting a severe multi-target autoimmune aggression. The association of hepatic injury--not explained by prior hepatic disease, B or C hepatitis virus infection or history of alcohol abuse--was encountered in 17% of the cases, without a significant influence on the renal and the general outcome. The outcome of rifampicin-induced ARF is generally favourable, with complete recovery of the renal function within 30 days in 52% of the cases and within 90 days in 92% of the cases. The mortality rate was 3.5%, compared to 21% for the overall ARF population treated during the same period (p < 0.05).

Topics: Acute Kidney Injury; Adult; Aged; Anemia, Hemolytic; Antibiotics, Antitubercular; Female; Humans; India; Male; Middle Aged; Retrospective Studies; Rifampin

We report a case of borderline tuberculoid leprosy complicated by a median nerve abscess, acute renal failure secondary to rifampicin-induced haemolysis and duodenal ulceration secondary to steroid use. Rifampicin induced hameolysis is a rare and probably under-reported complication of leprosy multi-drug therapy. It should be considered when patients complain of flu-like symptoms after taking their monthly rifampicin.

Topics: Abscess; Acute Kidney Injury; Adult; Female; Hemolysis; Humans; Leprostatic Agents; Leprosy, Borderline; Magnetic Resonance Imaging; Median Nerve; Peptic Ulcer; Rifampin

The side effects of rifampicine due to an immunoallergic mechanism are rare and usually observed during discontinued treatment or administration of high doses.. An immediate hypersensitivity reaction with anaphylactic manifestations and increase in IgE occurred in a 39 year-old man suffering from resistant tuberculosis. The reaction occurred within the first hour following a low dose of rifampicin administered in a desensitisation attempt, the outcome of which was favourable after administration of corticosteroids and antihistamines. A type II hypersensitivity reaction occurred in a 76 year-old male patient in the form of thrombopenia on D76 of a twice weekly treatment, diagnosed because of hemoptysis with normalisation of platelet level on withdrawal of rifampicin. An immune complex hypersensitivity reaction was responsible for hepato-renal failure on D68 of twice weekly treatment and required permanent withdrawal of rifampicin and dialysis, which led to subsequent improvement.. These clinical cases illustrate the variability of the hypersensitivity mechanisms observed with rifampicin, the difficulty in imputability tests and methods for immunological confirmation, the interest of continuous treatment which avoids a certain number of these accidents, and that of desensitisation during immediate hypersensitive reactions which permits the continuation this major anti-tuberculosis drug.

Topics: Acute Kidney Injury; Adult; Aged; Anaphylaxis; Antibiotics, Antitubercular; Antigen-Antibody Complex; Desensitization, Immunologic; Drug Hypersensitivity; Humans; Hypersensitivity, Immediate; Liver Failure; Male; Platelet Count; Rifampin; Thrombocytopenia; Time Factors

Topics: Acute Kidney Injury; Adolescent; Cluster Analysis; Drug Hypersensitivity; Female; Follow-Up Studies; Humans; Pedigree; Rifampin; Risk Assessment; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Humans; Rifampin

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.. 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.. 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.. 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.

Topics: Acute Kidney Injury; Adult; Aged; Antibiotics, Antitubercular; Drug Administration Schedule; Female; Humans; Leprosy; Male; Middle Aged; Oliguria; Prognosis; Rifampin; Tuberculosis, Lymph Node

Topics: Acute Kidney Injury; Antibiotics, Antitubercular; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Disease; Acute Kidney Injury; Antibiotics, Antitubercular; Biopsy; Humans; Kidney; Male; Middle Aged; Nephritis, Interstitial; Rifampin

To explore the clinico-pathological features and possible pathogenesis of rifampicin-associated acute renal failure (ARF).. The clinico-pathological features of 4 patients with Rifampicin-associated ARF were analyzed. Rifampicin-dependent antibody in the patient's serum was detected with Coomb's test.. 4 cases with rifampicin-associated ARF was distinguished from 202 in-patients with ARF in 5 years(1.98%). Most of them had infection before the occurrence of ARF. Clinical features were characterized by fever, fatigue and gastro-intestinal symptoms after taking rifampicin (especially when it was reused). Oliguria or anuria developed suddenly. Laboratory data showed hemolytic anemia, thrombocytopenia and decline of renal function. Some also had impaired liver function. Renal biopsy revealed acute tubular necrosis in 3 cases and acute interstitial nephritis in 1 case. Serum rifampicin-dependent antibody was positive in all the cases.. Rifampicin-associated ARF is not rare clinically, especially in those rifampicin re-exposure patients. Renal function should be closely monitored in susceptible patients. Detection of serum rifampicin-dependent antibody may be helpful to distinguish this group of ARF patients.

Topics: Acute Kidney Injury; Adult; Female; Humans; Kidney; Male; Middle Aged; Rifampin

A 53-year-old woman was treated for recurrent pulmonary tuberculosis with reintroduction of rifampicin after a medication-free interval of 10 years. After taking the first dose, she developed severe hemolytic anemia and oliguric acute renal failure and required temporary hemodialysis. The fulminant clinical course was compatible with rifampicin-induced acute renal failure. The renal function of this patient completely recovered after discontinuation of rifampicin and temporary hemodialysis. Since renal biopsy and anti-rifampicin antibodies cannot offer a definite diagnosis of rifampicin-induced acute renal failure, we must emphasize the importance of a clinical diagnosis of rifampicin-induced acute renal failure and complete history taking. Re-exposure is a critical factor. In this case, the rifampicin-free interval was as long as 10 years. Because of the feasible prognosis, reintroduction of rifampicin for recurrent pulmonary tuberculosis should not be abandoned, but the infrequent and life-threatening side effects should be kept in mind.

Topics: Acute Kidney Injury; Antibiotics, Antitubercular; Female; Humans; Middle Aged; Rifampin

Since 1971, 55 case-reports of rifampicin-induced acute renal failure (ARF) have been published. Covic et al described 60 consecutive cases of rifampicin-induced ARF during a period of eight years (1987-1995) from Iasi Dialysis Centre, Romania. The systenic data on this condition are not available, in view of the anecdotal nature of the observation from our country.. The aims of study were to analyze clinical features, course and outcome of ARF complicating rifampicin therapy at our centre.. We retrospectively studied prevalence, clinical presentations and renal histology and outcome of 11 cases (eight males, three females, aged 42-72 years) who were referred to Nephrology Unit of University Hospital, Varanasi for acute renal failure following retreatment with rifampicin between period of 1994-1999.. The gastrointestinal symptoms (abdominal pain, nausea and vomiting) and 'flu like' (fever, weakness and body ache) syndrome were the most frequent presenting features. The clinical signs of intravascular hemolysis were observed in four cases. The commonest laboratory findings included: Anaemia (7), leukocytosis (5), thrombocytopenia (3) and toxic hepatitis in (2) patients. Toxic hepatitis, hemolysis and ARF was seen in one patient in combination. The typical clinical features of allergic interstitial nephritis and acute tubular necrosis were seen in six and two patients respectively. Renal biopsy in three cases revealed; crescentic GN (1) and ATN in (2) patients. Acute renal failure complicating rifampicin accounted for 1.8% (11/607) of all ARF cases hospitalized in our centre during the study period. Renal function returned to normal in nine cases and one patient died on account of hepatic failure (toxic hepatitis). The patients with crescentic GN remained anuric and became dialysis dependent. Thus, clinical course of rifampicin induced ARF was favourable; with only one mortality, compared to a 18% mortality rate among all ARF patients.. Acute renal failure complicating rifampicin therapy is not an uncommon condition, and typically occurs after reintroduction of rifampicin. The renal prognosis is usually favourable. Intermittent or interrupted therapy appears to be a significant risk factor for the development of acute renal failure.

Topics: Acute Kidney Injury; Adult; Age Distribution; Aged; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Humans; Incidence; India; Male; Middle Aged; Retrospective Studies; Rifampin; Risk Factors; Sex Distribution; Tuberculosis

Topics: Acute Kidney Injury; Adult; Amoxicillin; Anti-Bacterial Agents; Antibiotics, Antitubercular; Female; Guidelines as Topic; Humans; Meningitis, Pneumococcal; Penicillins; Rifampin; Time Factors; Vancomycin

Topics: Acute Kidney Injury; Antibiotics, Antitubercular; Humans; Male; Middle Aged; Rifampin

Topics: Acute Kidney Injury; Antibiotics, Antitubercular; Humans; Rifampin

Rifampicin is one of the most effective antibiotics used for the treatment of tuberculosis and severe staphylococcal infections. Intermittent administration of high doses of rifampicin has been associated with frequent adverse reactions, including hepatotoxicity and nephrotoxicity, sometimes resulting in acute renal failure. We describe a case of rifampicin-associated acute renal failure, with biopsy findings of tubulointerstitial nephritis; inflammatory cells were characterized by immunohistochemistry, which showed immunoreactivity for CD3 and CD5 (T lymphocytes) and for CD68 (macrophages). The patient presented with a very rapid systemic reaction to the offending drug and rapid deterioration of renal function, which required dialysis treatment. The response to rifampicin discontinuation was excellent: no further therapy was required, as renal function began to improve within several days and returned to normal values (serum creatinine 1.17 mg/dl) seven months after the onset of symptoms. When prescribing rifampicin the physician should investigate previous use of the drug, because re-exposure is a critical factor in predicting the possibility of drug-induced acute renal failure.

Topics: Acute Disease; Acute Kidney Injury; Aged; Antibiotics, Antitubercular; Humans; Kidney; Male; Nephritis, Interstitial; Renal Dialysis; Rifampin; Tuberculosis, Pulmonary

We report a case of pulmonary tuberculosis with acute renal failure caused by readministration of Rifampicin (RFP). A 73 year-old man was admitted to a certain hospital complaining with dyspnea on exertion. As his sputum smear was positive for acid-fast bacilli, he was transferred to our hospital for the isolation and treatment. He was diagnosed as lung tuberculosis and was administrated RFP, Isoniazid (INH) and Ethambutol (EB). On the 20th day after the initiation of treatment, the administration of drugs were suspended, because of liver dysfunction. After recovery of liver dysfunction, we have readministered antituberculous drugs, starting with EB, then INH, and finally RFP. On the 22nd day after the readministration of RFP, acute renal failure was observed. All medications were suspended and we started treatment with hydration and furosemide. His renal function recovered after 7 weeks. Histopathological examination of the kidney revealed interstitial infiltration and tubular nephritis. According to the histopathological examination and the clinical course, we concluded acute renal failure was induced by the readministration of RFP. This case suggests that we have to pay attention to renal side effect of RFP in the course of readministration.

Topics: Acute Kidney Injury; Aged; Antibiotics, Antitubercular; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Male; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adult; Chemical and Drug Induced Liver Injury; Humans; Leprostatic Agents; Leprosy, Tuberculoid; Male; Rifampin

Since 1971, 55 case-reports of rifampicin-induced ARF have been published, but systematic data on this condition are not available, in view of the disparate nature of the observations.. We retrospectively assessed prevalence, clinical and biochemical features, and prognostic factors of 60 consecutive cases (41 males/19 females, age 22-68 years), who were admitted to the Iasi Dialysis Centre from 1987 to 1995 for acute renal failure (ARF) following re-treatment with rifampicin.. The clinical appearance consisted mainly of gastrointestinal and 'flu-like' symptoms and clinical signs of intravascular haemolysis (the latter in 17% of cases). Frequent laboratory findings were anaemia (96% of cases), leukocytosis (63%), and thrombocytopenia (50%). Severe anaemia was associated with marked haemolysis (25% cases), thrombocytopenia, longer anuria, and slower rate of renal function recovery. Signs of hepatic injury were found in 25% of patients, but it did not seem to affect the outcome of renal function. Prognostic factors in post-rifampicin ARF proved to be the following: the duration of the anuric phase (correlated with the number of dialysis sessions and with the rate of decrease of azotaemia) and the severity of the immunological abnormalities and inflammatory syndrome (haemolysis, leukocytosis, hypergammaglobulinaemia). Post-rifampicin ARF accounted for 16.6% of all ARF cases hospitalized in our Centre during the studied period. Its clinical course was favourable; the mortality rate was only 1.6% (1 case), compared to a 20% general mortality rate among all ARF patients. Full recovery of renal function was achieved in 40% and 96% of patients, 30 and 90 days respectively from onset.. ARF after treatment with rifampicin is not an uncommon condition, especially when tuberculosis prevalence is high, but renal prognosis is usually favourable. Thrombocytopenia, immune haemolytic anaemia, and intravascular haemolysis are frequent complications which are associated with a more severe renal injury.

Topics: Acute Kidney Injury; Adult; Aged; Anemia; Antibiotics, Antitubercular; Female; Humans; Liver; Male; Middle Aged; Prognosis; Retrospective Studies; Rifampin; Thrombocytopenia

Topics: Acute Kidney Injury; Adult; Antibiotics, Antitubercular; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Humans; Kidney Function Tests; Male; Middle Aged; Rifampin

An elderly patient with borderline tuberculoid Hansen's disease (leprosy) developed the diaminodiphenylsulphone syndrome after approximately 8 weeks of multi-drug therapy comprising dapsone and rifampicin. Postmortem histological examination, following autopsy, demonstrated features consistent with drug-induced hepatitis, tubulo-interstitial nephritis and myocarditis. Although these could have been engendered by dapsone toxicity, it was thought that a concommitant adverse reaction to rifampicin, which is known to be hepatotoxic, nephrotoxic and possibly capable of predisposing to the dapsone syndrome, could not be excluded.

Topics: Acute Kidney Injury; Aged; Chemical and Drug Induced Liver Injury; Dapsone; Diagnosis, Differential; Drug Therapy, Combination; Fatal Outcome; Humans; Kidney; Leprosy; Liver; Male; Myocarditis; Myocardium; Nephritis, Interstitial; Rifampin

This case study reveals an unusual finding of rapidly proliferative crescentic glomerulonephritis in a patient treated with rifampin who had no other identifiable causes for developing this disease. This patient underwent a 10-month regimen of rifampin and isoniazid for pulmonary tuberculosis and was discovered to have developed signs of severe renal failure five weeks after completion of therapy. Renal biopsy revealed severe glomerulonephritis with crescents, electron dense fibrillar deposits and moderate lymphocytic interstitial infiltrate. Other possible causes of rapidly progressive glomerulonephritis were investigated and ruled out. This report documents the unusual occurrence of rapidly progressive glomerulonephritis with crescents and fibrillar glomerulonephritis in a patient treated with rifampin.

Topics: Acute Kidney Injury; Adult; Biopsy; Drug Therapy, Combination; Glomerulonephritis; Humans; Isoniazid; Kidney Glomerulus; Male; Microscopy, Electron; Rifampin; Tuberculosis, Miliary; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adult; Female; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Miliary; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Anabolic Agents; Anti-Inflammatory Agents, Non-Steroidal; Female; Flavonoids; Furosemide; Humans; Kaempferols; Middle Aged; Nandrolone; Nandrolone Decanoate; Povidone; Rifampin

Topics: Acute Kidney Injury; Drug Hypersensitivity; Humans; Male; Middle Aged; Rifampin; Time Factors

We report on a patient who developed life-threatening thrombocytopenia and acute renal failure after the reinstitution of rifampicin therapy for pulmonary tuberculosis. This combined reaction is rarely reported. Supportive treatment and withdrawal of rifampicin led to complete recovery. The increased incidence of drug-resistant tuberculosis and the need for the reintroduction of rifampicin therapy may lead to more such reactions being observed.

Topics: Acute Kidney Injury; Adult; Humans; Male; Rifampin; Severity of Illness Index; Thrombocytopenia; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Aged; Anemia, Hemolytic; Female; Humans; Rifampin

We present a patient acutely ill from severe tuberculous meningo-encephalitis, in whom acute hepatic and renal failure, due to intercurrent septic shock, precluded the administration of full systemic dosage of antituberculous drugs. Daily direct intraventricular administration of 5 mg rifampicin, via a subcutaneous Ommaya reservoir connected to a catheter placed in the right lateral cerebral ventricle, resulted in rapid improvement without neurological sequelae. Intraventricular rifampicin administration for 50 consecutive days was well-tolerated without local or systemic side-effects. In well-selected patients with severe tuberculous meningo-encephalitis, intraventricular rifampicin may safely and highly effectively be added to systemic antituberculous therapy.

Topics: Acute Kidney Injury; Catheters, Indwelling; Cerebral Ventricles; Humans; Infusion Pumps, Implantable; Liver Diseases; Male; Meningoencephalitis; Middle Aged; Rifampin; Shock, Septic; Tuberculosis, Meningeal

Topics: Acute Kidney Injury; Anemia, Hemolytic; Female; Humans; Middle Aged; Rifampin

Renal failure is a rare complication associated with the use of rifampin. Intravascular hemolysis leading to acute renal failure following rifampin therapy is extremely rare. Two patients with leprosy who developed hemolysis and acute renal failure following rifampin are reported.

Topics: Acute Kidney Injury; Adult; Anemia, Hemolytic; Hemolysis; Humans; Leprosy; Leprosy, Borderline; Leprosy, Tuberculoid; Male; Rifampin

Topics: Acute Kidney Injury; Adult; Hemolysis; Humans; Male; Rifampin

While receiving continuous daily rifampin therapy, a 57-year-old man developed acute renal failure and nephrogenic diabetes insipidus due to acute tubulointerstitial nephritis which was reversible by discontinuing the rifampin. Tubulointerstitial nephritis rarely develops during continuous rifampin therapy, and associated nephrogenic diabetes insipidus has not previously been reported. The majority of cases of tubulointerstitial nephritis due to rifampin have occurred following reintroduction of rifampin after an interruption in therapy. The clinical differences between patients developing tubulointerstitial nephritis during interrupted and continuous therapy are discussed.

Topics: Acute Kidney Injury; Diabetes Insipidus; Humans; Male; Middle Aged; Nephritis, Interstitial; Rifampin; Tuberculosis

Topics: Acute Kidney Injury; Adult; Humans; Male; Nephrotic Syndrome; Polymorphism, Genetic; Rifampin

Topics: Acute Kidney Injury; Adult; Chemical and Drug Induced Liver Injury; Humans; Male; Rifampin; Seizures

Acute renal failure developed in a patient with a normal serum creatinine level, after treatment with rifampin was begun for tuberculosis. Renal biopsy revealed an obstructive nephropathy due to tubular casts. Immunoperoxidase and immunofluorescence studies demonstrated the presence of heterogeneous light chains within these casts. This unique drug-induced renal disease is discussed with reference to the literature and to possible analogies with myeloma kidney.

Topics: Acute Kidney Injury; Adult; Humans; Immunoglobulin Light Chains; Kidney; Male; Multiple Myeloma; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Disease; Acute Kidney Injury; Adolescent; Adult; Aspirin; Dipyrone; Female; Humans; Male; Middle Aged; Nephritis, Interstitial; Rifampin

Two months after commencing continuous treatment with rifampicin, isoniazid, streptomycin and pyrazinamide for pulmonary tuberculosis a patient developed a nephrotic syndrome, acute nonoliguric renal failure and evidence of intravascular hemolysis. Renal biopsy revealed a severe crescentic nephritis with mild interstitial changes. The use of rifampicin has been associated with various renal abnormalities and this report documents the occurrence of a rapidly progressive crescentic glomerulonephritis presenting as nephrotic syndrome in a patient receiving continuous treatment with rifampicin.

Topics: Acute Disease; Acute Kidney Injury; Adult; Glomerulonephritis; Humans; Kidney Glomerulus; Male; Nephrotic Syndrome; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Female; Humans; Middle Aged; Rifampin

Topics: Acute Kidney Injury; Aged; Female; Humans; Rifampin

Topics: Acute Kidney Injury; Antibodies; Blood Urea Nitrogen; Complement C3; Creatinine; Drug Therapy, Combination; Humans; Isoniazid; Kidney Glomerulus; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

A leprosy patient who developed acute renal failure on multidrug therapy is reported. The patient had initially received a once-weekly dose of rifampin and after he had stopped taking the drug for a time, was given rifampin on a once-monthly dose schedule. He recovered completely from his acute renal failure. Kidney biopsy showed interstitial nephritis with mononuclear and eosinophilic cellular infiltrates.

Topics: Acute Kidney Injury; Adult; Dapsone; Drug Hypersensitivity; Drug Therapy, Combination; Humans; Leprosy; Male; Nephritis, Interstitial; Rifampin

Topics: Acute Kidney Injury; Adult; Anaphylaxis; Antitubercular Agents; Drug Hypersensitivity; Female; Humans; Male; Middle Aged; Rifampin

Renal failure is a rare complication associated with the use of rifampicin for the treatment of tuberculosis, usually occurring well into the course of therapy. The following is a report of 2 cases of rifampicin-induced renal insufficiency. In the first case oligo-anuric renal failure occurred on the thirteenth day of treatment, after the patient had taken only 9 doses of medication. The second case occurred in a patient who developed renal failure while on daily therapy in the hospital. A literature review revealed 83 other reported cases of rifampicin-induced renal insufficiency. Intermittent or interrupted therapy appears to be a significant risk factor for the development of this complication.

Topics: Acute Kidney Injury; Aged; Female; Humans; Male; Middle Aged; Rifampin; Risk; Tuberculosis

Topics: Acute Kidney Injury; Aged; Humans; Male; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Dehydration; Humans; Immunoglobulin Light Chains; Male; Middle Aged; Proteinuria; Rifampin

Acute renal failure following intermittent or discontinuous rifampicin therapy is a relatively infrequent clinical observation. Many pathogenetic mechanisms for the renal failure have been proposed, including intravascular hemolysis with hemoglobinuria and its consequent nephrotoxicity. We report the case of a patient who used rifampicin in a discontinuous fashion and developed hemolysis with nonoliguric acute renal failure. Most reported cases of antirifampicin antibodies are of the IgM class; thus, the development of an IgG antirifampicin antibody is of interest, especially because of its strong in vivo hemolytic properties. In addition, this patient developed a nonoliguric uremic course that did not require dialysis, both of which are distinctly unusual for this clinical setting.

Topics: Acute Kidney Injury; Hemolysis; Humans; Immunoglobulin G; Male; Middle Aged; Rifampin

Topics: Acute Kidney Injury; Female; Humans; Middle Aged; Nephritis, Interstitial; Rifampin

In a 48-years old woman, intermittent rifampicin treatment induced an immunoallergic reaction with digestive disorders, haemolysis, acute renal failure and prolonged prothrombin time. The reintroduction of rifampicin, 17 days later, resulted in a similar, though more severe, reaction associated with diffuse haemorrhages from disseminated intravascular coagulation, this association being exceptional. The responsibility of rifampicin was demonstrated by the chronological relationship between clinical symptoms and administration of the drug, and by the presence in the patient's serum of anti-rifampicin antibodies. The antigen-antibody reaction with complement activation and haemolysis probably explains the disseminated intravascular coagulation.

Topics: Acute Kidney Injury; Antibodies; Antigen-Antibody Reactions; Complement Activation; Disseminated Intravascular Coagulation; Drug Hypersensitivity; Female; Hemolysis; Humans; Middle Aged; Rifampin

19 antibodies specific for 11 different drugs were extensively tested in the presence of the drug against a panel of red cells including common and public minus phenotypes. High incidence blood group antigens were shown to be specific receptors for several drug-antibody complexes proving thereby that red blood cells play more than an "innocent bystander" role in drug induced immune hemolytic anemias.

Topics: Acute Kidney Injury; Anemia, Hemolytic; Antigen-Antibody Complex; Blood Group Antigens; Erythrocyte Membrane; Humans; Phenotype; Receptors, Immunologic; Rifampin

Topics: Acute Kidney Injury; Adult; Humans; Male; Rifampin; Urethritis

We describe the clinical and pathological features of acute renal failure which occurred in a patient receiving a first course of antituberculous therapy, including daily rifampicin. Renal biopsy specimens demonstrated an interstitial nephritis. The renal lesion resolved three weeks after the cessation of rifampicin, as evidenced by improvement in renal function and the return of nuclear magnetic resonance tomographic studies to normal. This is only the fifth reported instance of renal impairment following continuous rifampicin therapy, despite widespread use of the drug in a daily dose. The possible toxic interaction of rifampicin and antituberculous drugs which are excreted predominantly by the kidneys is also described.

Topics: Acute Kidney Injury; Adult; Biopsy, Needle; Humans; Magnetic Resonance Spectroscopy; Male; Nephritis, Interstitial; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Anemia, Hemolytic; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

5 patients with acute renal failure (3 with thrombopenia and hemolysis) induced by the reintroduction of rifampicin are described. No correlation was found between the severity of clinical manifestations and the total dose taken by the patients. In all but 1 patient, antirifampicin antibodies were detected. Antibodies suggested to be of the IgM class were detected in all 3 patients with hematological disorders. The pattern of non-specific acute tubular necrosis found in the 2 biopsied patients, indistinguishable from that of ischemic origin, raised the possibility of a vascular-mediated damage. In 3 patients, the possibility of a triggering immunoallergic mechanism is discussed.

Topics: Acute Kidney Injury; Adult; Aged; Antibodies; Female; Humans; Kidney; Male; Middle Aged; Rifampin

Topics: Acute Kidney Injury; Adult; Drug Hypersensitivity; Humans; Male; Recurrence; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Aged; Female; Humans; Peritoneal Dialysis; Radiography; Rifampin; Tuberculosis, Lymph Node; Tuberculosis, Miliary

Topics: Acute Kidney Injury; Drug Therapy, Combination; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Female; Humans; Male; Middle Aged; Rifampin

Topics: Acute Kidney Injury; Adult; Drug Administration Schedule; Female; Humans; Rifampin

Topics: Acute Kidney Injury; Aged; Female; Hemolysis; Humans; Rifampin

Topics: Acute Kidney Injury; Adult; Female; Humans; Kidney; Kidney Tubular Necrosis, Acute; Male; Middle Aged; Respiratory Tract Infections; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adolescent; Adult; Aged; Chemical and Drug Induced Liver Injury; Humans; Isoniazid; Male; Middle Aged; Rifampin

Intermittent rifampicin therapy has been reported to commonly cause a flu-like illness with chills and fever sometimes associated with acute renal failure. This report describes a fourth case of partially reversible insidious renal damage associated with continuous rifampicin therapy and provides evidence that it is not the results of light chain proteinuria as previously suggested. A retrospective review of data relating to renal function in 89 tuberculous patients indicated that increased plasma urate concentration was commonly associated with ethambutol therapy.

Topics: Acute Kidney Injury; Bicarbonates; Creatinine; Ethambutol; Female; Glycosuria; Humans; Hypokalemia; Male; Middle Aged; Retrospective Studies; Rifampin; Tuberculosis, Pulmonary

Rifampicin is a widely used anti-tuberculous drug. Administered daily, only minimal side-effects occur. With intermittent therapy and, as happened in the present case, when the drug is administered after an interruption of treatment, severe adverse reactions [5] (thrombocytopenia, renal failure, and haemolysis) may occur.

Topics: Acute Kidney Injury; Aged; Anemia, Hemolytic; Antibodies; Drug Administration Schedule; Humans; Immunoglobulin G; Immunoglobulin M; Male; Rifampin; Time Factors

Topics: Acute Kidney Injury; Adult; Humans; Rifampin

Topics: Acute Kidney Injury; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

A relatively mild nonoliguric acute renal failure developed early in the course of daily rifampin treatment in a 54-year-old man who was receiving concomitant steroid therapy. The renal lesion was an acute interstitial nephritis characterized by tubular dysfunction:inability to concentrate urine, increase in fractional excretion of sodium and uric acid, and glycosuria with normal blood glucose values. All abnormalities resolved promptly upon withdrawal of rifampin while steroid therapy was gradually reduced. The documents the fact that rifampin-induced nephropathy can occur in the course of a continuous daily regimen and may be favorably influenced by steroid administration.

Topics: Acute Kidney Injury; Drug Therapy, Combination; Humans; Male; Middle Aged; Prednisone; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Humans; Rifampin

The authors report a new case of acute renal insufficiency with Rifampicin. They evoke the clinical background which is characteristic of these anuric tubular nephritis. They recall the different complications with Rifampicin to which they can be associated and the different mechanisms which can be at the origin of this affection as well as the difficulties to reveal them. Then, they insist on the prevention of renal accidents within the frame of our present knowledge.

Topics: Acute Kidney Injury; Anuria; Chemical and Drug Induced Liver Injury; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Two cases are reported of hemolytic crisis and acute anuria after intermittent rifampicin medication. Immunologic tests demonstrate that the hemolysis was of the drug-induced heteroimmune type whereas the pathogenesis of the anuria was uncertain. For both complications the prognosis is good.

Topics: Acute Kidney Injury; Aged; Antibodies; Anuria; Drug Therapy, Combination; Female; Hemolysis; Humans; Male; Middle Aged; Rifampin; Time Factors; Tuberculosis, Lymph Node; Tuberculosis, Renal

Topics: Acute Kidney Injury; Antigen-Antibody Complex; Contraceptives, Oral; Drug Hypersensitivity; Drug Interactions; Humans; Liver; Methods; Rifampin

We report a case of hepatorenal failure complicating rifampicin administration in which rifampicin-dependent antibodies were demonstrated. Hepatorenal failure during rifampicin treatment has been reported before but in none of the previous cases were rifampicin-dependent antibodies described.

Topics: Acute Kidney Injury; Adult; Antibodies; Chemical and Drug Induced Liver Injury; Humans; Liver Diseases; Male; Rifampin

Topics: Acute Kidney Injury; Aged; Anuria; Humans; Male; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adult; Chemical and Drug Induced Liver Injury; Humans; Knee Injuries; Knee Joint; Liver; Male; Radiography; Rifampin; Tuberculosis, Osteoarticular

Topics: Acute Kidney Injury; Drug Hypersensitivity; Humans; Kidney Glomerulus; Kidney Tubules; Male; Middle Aged; Rifampin

Topics: Acute Kidney Injury; Female; Humans; Middle Aged; Rifampin; Tuberculosis, Pulmonary

A case of acute renal insufficiency associated with acute hepatitis that arose in the course of intermittent rifampicine management is reported. Specific reagin-type antibodies were noted in the circulating blood. The clinical, morphological and pathogenetic aspects of the case are compared with those of kidney disease caused by penicillin. While certain clinical features appear in both situations, the histological and immunofluorescence data suggest that two separate pathological entities are involved.

Topics: Acute Kidney Injury; Chemical and Drug Induced Liver Injury; Humans; Liver; Male; Middle Aged; Rifampin

Starting again a Rifampicin treatment gave rise to an acute renal insufficiency, reversible by hemodialysis. This incident resulted from an immunopathological conflict revealed by the presence of anti-Rifampicin antibodies. Renal needle biopsy did not show any immune deposits. The mechanism of these incidents is discussed. Authors draw attention to the necessity of avoiding discontinuous Rifampicin treatment.

Topics: Acute Kidney Injury; Biopsy, Needle; Drug Hypersensitivity; Female; Humans; Kidney Tubules; Middle Aged; Nephritis; Renal Dialysis; Rifampin

A patient who was receiving rifampin treatment for tuberculosis developed heterogenous light-chain proteinuria and insidious renal failure after a period of fluid restriction. The renal damage was characterized pathologically by an interstitial nephritis with invasive tubular casts and an associated renal vein thrombosis. The possible role of the light-chain proteinuria in the pathogenesis of the renal failure is discussed.

Topics: Acute Kidney Injury; Dehydration; Humans; Immunoglobulin Light Chains; Male; Middle Aged; Nephritis, Interstitial; Proteinuria; Rifampin

Topics: Acute Kidney Injury; Adult; Humans; Male; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Humans; Male; Middle Aged; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Aged; Female; Humans; Rifampin

A 45-year-old man treated for pulmonary tuberculosis with daily drug therapy, including rifampin, developed acute renal failure manifested by ebinophilia, skin rash, and increased serum blood urea nitrogen and creatinine. The renal failure was marked by a prolonged course and incomplete recovery. Renal biopsy showed tubulointerstitial nephritis with nonspecific glomerular mesangial proliferation. Fluorescence staining showed the presence of IgG, IgA, AgM, and C3 deposits in glomeruli, as well as IgE deposits along the tubules. This report describes a new hazard of rifampin therapy that might have developed, in part, because of coexisting hepatic dysfunction.

Topics: Acute Kidney Injury; Humans; Kidney; Liver; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Aged; Ethambutol; Female; Humans; Immunoglobulin Light Chains; Isoniazid; Male; Middle Aged; Proteinuria; Rifampin; Tuberculosis, Lymph Node; Tuberculosis, Renal

Five episodes of acute renal failure due to rifampicin (R-ARF) were observed in four patients and the clinical and histological data were compared with the records of 52 episodes reported in the literature. The bulk of data supports the assumption that the by far most frequent renal injury responsible for R-ARF is acute tubular necrosis produced by a vasomotor mechanism. Nevertheless a few data, above all immunohistological findings, suggest the local presence of allergic process. It may be, that the development of an immunological renal lesion is prevented or blunted by the consequences of vasomotor effects.

Topics: Acute Kidney Injury; Humans; Rifampin

In a patient with tuberculosis and acute renal failure related to administration of therapeutic rifampin, treatment was discontinued for five weeks. It was reinstituted three weeks later. Unlike other patients previously described, the expected adverse renal reaction occurred only gradually and without symptoms, although tubular and glomerular disease developed. Also unique was a striking deposition of immunoglobulin about the tubules. This finding, in association with interstitial nephritis and tubular glycosuria, is similar to an experimental autologous renal disease mediated by antibody to tubular basement membrane.

Topics: Acute Kidney Injury; Autoantibodies; Basement Membrane; Complement C3; Creatinine; Fibrinogen; Glomerulonephritis; Glycosuria; Humans; Immunoglobulin A; Immunoglobulin G; Kidney Tubules; Male; Methods; Middle Aged; Nephritis, Interstitial; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adult; Humans; Kidney; Male; Nephritis, Interstitial; Peritonitis, Tuberculous; Rifampin

Topics: Acute Kidney Injury; Humans; Male; Middle Aged; Rifampin; Tuberculosis

A clinical presentation is made of a 2-3 year follow-up of six cases of acute renal failure that have been reported earlier. The patients had developed transient renal failure after the intermittent administration of rifampicin. The stage of olig-anuria lasted for 1-3 weeks, and five of the patients were treated by hemodialysis. Two of the patients died due to unrelated causes during the follow-up period. The four patients re-examined were clinically cured. Pathologic findings by light microscopy and immunofluorescence at biopsy were scarce. Nothing abnormal was seen by electron microscopy in two of the cases studied. Renal function was normal. In three cases the excretion at 131I-hippuran renography was slightly slowed. Although in the acute stage the renal lesions histologically appeared toxic, evidence suggestive of an immunological mechanism cannot be excluded.

Topics: Acute Kidney Injury; Adult; Aged; Female; Follow-Up Studies; Humans; Immunoglobulins; Male; Middle Aged; Renal Dialysis; Rifampin

Topics: Acute Kidney Injury; Aged; Ethambutol; Humans; In Vitro Techniques; Isoniazid; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Humans; Kidney Diseases; Male; Middle Aged; Rifampin

Topics: Acute Kidney Injury; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Hemolysis; Humans; Liver; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adult; Female; Humans; Kidney Tubular Necrosis, Acute; Middle Aged; Rifampin; Time Factors; Tuberculosis

Two patients who developed reversible renal failure during intermittent rifampicin therapy are described. Both had febrile reactions to rifampicin. The first was also found to have uraemia associated with swelling of the glomerular endothelial cells. The second developed tubular necrosis unassociated with haemolysis or shock. The pathogenesis of the renal lesion in these two patients, as revealed by light microscopy, immunofluorescence studies and electron microscopy, is discussed.

Topics: Acute Kidney Injury; Adult; Antibodies; Endothelium; Ethambutol; Fever; Fibrin; Humans; Immune Complex Diseases; Ischemia; Kidney Glomerulus; Kidney Tubules; Male; Necrosis; Rifampin; Tuberculosis, Pulmonary; Uremia

Topics: Acute Disease; Acute Kidney Injury; Anticoagulants; Contraceptives, Oral; Digitoxin; Female; Hemolysis; Humans; Nephritis, Interstitial; Rifampin; Thrombocytopenia; Tuberculosis

Topics: Acute Kidney Injury; Adult; Aged; Anaphylaxis; Chronic Disease; Female; Humans; Male; Methods; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Humans; Kidney; Kidney Glomerulus; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Drug Hypersensitivity; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adult; Anuria; Biopsy; Creatinine; Drug Hypersensitivity; Humans; Male; Middle Aged; Rifampin; Time Factors; Tuberculosis, Pulmonary; Uric Acid

Topics: Acute Kidney Injury; Adult; Female; Humans; Male; Middle Aged; Rifampin

Topics: Acute Kidney Injury; Antibodies; Biopsy; Female; Humans; Kidney; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Amebiasis; Antimalarials; Cholera; Drug Resistance, Microbial; Encephalitis; Glomerulonephritis; Helminthiasis; Hepatitis B Antigens; Humans; Leprosy; Malaria; Neurologic Manifestations; Parasitic Diseases; Pyrimethamine; Rifampin; Sulfonamides; Thiabendazole; Tropical Medicine; Trypanosomiasis, African

Topics: Acute Kidney Injury; Adult; Aged; Complement Fixation Tests; Female; Humans; Male; Middle Aged; Renal Dialysis; Rifampin; Tuberculosis

Topics: Acute Kidney Injury; Antibodies; Dose-Response Relationship, Drug; Drug Hypersensitivity; Hemorrhagic Disorders; Humans; Respiratory Insufficiency; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Anuria; Humans; Lymphocyte Activation; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Age Factors; Anuria; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary; Uremia

Topics: Acute Kidney Injury; Aminosalicylic Acids; Chemical and Drug Induced Liver Injury; Drug Therapy, Combination; Female; Humans; Middle Aged; Pain; Rifampin; Shock, Septic; Time Factors; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Aged; Antibody Formation; Bilirubin; Biopsy; Diarrhea; Female; Humans; Kidney; Nausea; Rifampin; Urea

Topics: Acute Kidney Injury; Antibody Formation; Drug Hypersensitivity; Humans; Male; Middle Aged; Proteinuria; Rifampin; Specific Gravity; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Agglutination Tests; Anemia, Hemolytic; Antibodies; Female; Hemolysis; Humans; Middle Aged; Rifampin; Tuberculosis, Renal

Topics: Acute Kidney Injury; Adult; Humans; Male; Nephritis, Interstitial; Rifampin

Topics: Acute Kidney Injury; Anti-Bacterial Agents; Cephalexin; Cephaloridine; Cephalothin; Drug Hypersensitivity; Gentamicins; Humans; Kanamycin; Kidney Diseases; Kidney Tubules; Nephritis; Nephritis, Interstitial; Penicillins; Polyenes; Polymyxins; Rifampin

Topics: Acute Disease; Acute Kidney Injury; Adult; Ambulatory Care; Amylases; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; Hematologic Diseases; Humans; Isoniazid; Liver; Male; Pancreatitis; Prednisolone; Recurrence; Rifampin; Stimulation, Chemical; Streptomycin; Transaminases; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adolescent; Cycloserine; Drug Therapy, Combination; Dyspnea; Ethambutol; Ethionamide; Fever; Follow-Up Studies; Headache; Humans; Purpura, Thrombocytopenic; Pyrazinamide; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Antibodies; Drug Therapy, Combination; Ethambutol; Fever; Headache; Hemorrhage; Humans; Liver Function Tests; Nausea; Purpura, Thrombocytopenic; Rifampin; Time Factors; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adult; Bilirubin; Biopsy; Creatinine; Female; Humans; Kidney; Kidney Function Tests; Male; Middle Aged; Purpura, Thrombocytopenic; Rifampin; Transaminases; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Adult; Agglutination Tests; Anemia, Hemolytic; Antibodies, Anti-Idiotypic; Antigen-Antibody Reactions; Erythrocytes; Haptens; Humans; Immunoglobulins; Male; Middle Aged; Rifampin; Trypsin

Topics: Acute Kidney Injury; Adult; Anuria; Drug Hypersensitivity; Fibrinogen; Fluorescent Antibody Technique; Furosemide; Humans; Immunoglobulins; Male; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Antibodies; Antigen-Antibody Complex; Anuria; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pleural

Topics: Acute Kidney Injury; Antibodies; Drug Hypersensitivity; Humans; Male; Middle Aged; Recurrence; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Chronic Disease; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Anuria; Humans; Rifampin

Topics: Acute Kidney Injury; Diarrhea; Ethionamide; Female; Humans; Isoniazid; Middle Aged; Renal Dialysis; Rifampin; Skin Manifestations; Tuberculosis, Pulmonary; Vomiting

Topics: Acute Kidney Injury; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Kidney Injury; Antibodies; Complement Fixation Tests; Humans; Kidney; Male; Middle Aged; Radioimmunoassay; Rifampin; Tuberculosis, Pleural

Topics: Acute Kidney Injury; Adult; Female; Humans; Rifampin

Topics: Acute Kidney Injury; Adult; Drug Hypersensitivity; Humans; Jaundice; Male; Rifampin; Thrombocytopenia

Topics: Acute Kidney Injury; Adolescent; Adult; Antibodies; Child; Complement Fixation Tests; Epistaxis; Female; Fever; Humans; Isoniazid; Male; Middle Aged; Rifampin; Streptomycin; Thrombocytopenia; Tuberculosis

Daily rifampicin in a single dose of 600 mg, combined with other drugs, usually streptomycin and isoniazid, was given to 49 patients for three months. It was planned to continue for another 15 months with twice-weekly rifampicin 1,200 mg plus isoniazid 900 mg, but the high incidence of side effects led to cessation of the intermittent regimen when only two patients had completed 18 months.Though there was no serious problem with daily treatment 11 patients (22%) were unable to continue rifampicin on the intermittent regimen. In 8 (16%) a pyrexial syndrome occurred. In one of these patients there was also temporary renal failure, and in another precipitous thrombocytopenia led to epistaxis and bleeding into the tongue and lips. Symptomless thrombocytopenia developed in two other patients, making three cases (6%) of thrombocytopenia in all.In 16 (33%) of the 49 patients antibodies to rifampicin were detected in the blood. Side effects occurred in 9 (56%) of these, including the three developing thrombocytopenia, but in only 2 (6%) of the 33 patients with no antibodies detected. This association of toxic reactions with antibodies is highly significant (P<0.001).

Topics: Acute Kidney Injury; Adolescent; Adult; Aged; Antibodies; Child; Coombs Test; Epistaxis; Female; Fever; Humans; Isoniazid; Lip; Male; Middle Aged; Oral Hemorrhage; Rifampin; Streptomycin; Thrombocytopenia; Tongue Diseases; Tuberculosis, Pulmonary