Adverse effects of anti-tuberculosis drugs in hemodialysis patients

<b>Introduction:</b> Chronic renal failure (CRF) patients in the terminal stage receiving hemodialysis in the presence of TB infection are recommended a course of treatment. However, the data about the safety of anti-TB drugs use in such patients is not enough. <b>Aim:</b> To analyse adverse effects of TB drugs in hemodialysis patients. <b>Material and Methods:</b> We studied 27 hemodialysis patients with newly diagnosed TB: 13 had active TB, 14 - post-TB changes in intrathoracic lymph nodes, lungs, bronchi or pleura. <b>Results:</b> 21/27 (77.8%) patients received TB treatment, 6/27(22.2%) without treatment due to complications of CRF. 12 of 21 (57.1%) patients received R, H, Z, E; 7/21 (33.3%) - Lfx, Mfx, Spx, Pt, PAS, Cs, Ter; 2/21 (9.5%) - Lzd and Bq. Adverse effects were: weakness, vertigo – 100%; neurotoxicity – 27%; hepatotoxicity – 15.4%; nephrotoxicity – 11.5%; toxic allergic reactions – 11.5%; incurable vomiting – 7.7%; cardiovascular complications – 7.7%; leukopenia – 7.7%; articular syndrome – 3.8%; glycaemic instability – 3.8%; weight loss – 3.8%. We had to cancel of 1 drug in 10/21 (47.6%) cases, and the whole TB treatment – in 1/21 (4.8%) cases. Withdrawal of Pt – 50%, R – 37.5%, Z – 37.5%, Lfx – 33.3%, H – 12.5%, E – 11.1%. Symptomatic treatment enabled not to cancel Mfx, Spx, Cs, Ter, Pas, Lzd, Bq. <b>Conclusions:</b> Most of hemodialysis patients with newly diagnosed tuberculosis received complete scheme of anti-tuberculosis treatment (77.8%). The first-line TB drugs were oftener used (57.1%). The most adverse effects were neurotoxicity (26.9%) and hepatotoxicity (15.4%). TB treatment was cancelled due to Pt –50%, R – 37.5%, and Z – 37. 5%. Mfx, Spx, Cs, Ter, Pas, Lzd, Bq were used less often, but demonstrated higher safety.