Abstract
Rationale: There are few studies for the treatment and its outcome of tuberculosis(TB) in patients with hemodialysis(HD). The aim of this study is to assess the side effects and the outcome of anti-tuberculosis treatment in patients with HD according to the Japanese guideline and to determine the mortality and its risk factors.
Methods: A retrospective analysis of clinical data of TB patients who received standard regimens containing isoniazid(INH), rifampicin(RFP), ethambutol(EB), and/or pyrazinamide(PZA) between 2005 and 14, was completed. We reviewed the prevalence of the side effects and the outcome, the mortality and its risk factors. The conventional dose of INH and RFP, and 10mg/kg every other day of EB is recommended.The ethical committee at the Jikei University approved this study.
Results: 415 patients were assessed. The number of HD patients was 16 and non HD was 399. There were no differences in the prevalence of liver damage(HREZ33.3%:23.9%/HRE10%:30.9%), rash(18.8%:19%), the rate of regimen change due to side effects(25%:12.3%), the recurrence rate(0%:1.5%), the positive rate of sputum culture in 2 months(6.2%:13.5%) and the hospital mortality(25%:9.5%) (HD: non HD). The mortality during a year from initiation of TB treatment was 29.2%. The regimen change(Hazard ratio(HR)10.84(p=0.05)), impossibility of ingestion(HR4.97(p=0.07)) and poor performance status(PS)(ECOG)(HR11.41(p=0.05)) might be risk factors of the mortality.
Conclusion: There are no differences in the prevalence of side effects and the outcome between HD and non HD patients. The regimen change, impossibility of ingestion and poor PS might be risk factors of the mortality.
- Copyright ©ERS 2015
