Nephrotoxicity risk evaluation in tuberculosis patients using a fixed dose or single tablet combination of anti-tuberculosis in Makassar, Indonesia Nurjannah Nurjannah1, Yulia Yusrini Djabir2,3*, Arif Santoso2,4, Muhammad Nasrum Massi5, Risfah Yulianty6
1. Postgraduate study program, Faculty of Pharmacy, Hasanuddin University, Makassar, Indonesia
2. Graduate School, Hasanuddin University, Makassar, Indonesia
3. Laboratory of Clinical Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar, Indonesia
4. Department of Pulmonology and Respiration, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
5. Department of Clinical Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
6. Laboratory of Pharmaceutical Chemistry, Faculty of Pharmacy, Hasanuddin University, Makassar, Indonesia
Abstract
Anti tuberculosis drugs (ATD) use may induce nephrotoxicity in tuberculosis patients. ATD can be prescribed as combination of single tablets (CST) or in fixed dose combination (FDC). This study aimed to evaluate the incidence of nephrotoxicity in patients receiving anti tuberculosis in FDC and CST regimens. Forty one TB patients were included in the study, 25 patients received ATD in FDC while 16 patients had CST regimen. Blood sampling was carried out prior to the initiation of ATD treatment to measure serum creatinine, glomerulus filtration rate (GFR) and blood urea levels. The patients were monitored during the course of ATD treatment for 2 months (intensive phase). At the end of intensive phase, the renal function parameters were measured again and compared with the baseline levels. The result shows that in general, there was a significant decrease in the mean serum creatinine without significant change in urea level following 2 months of ATD treatments. Meanwhile, the mean GFR value of both groups was found significantly improved after ATD treatment. The type of regimen given, either FDC or CST, did not seem to affect renal function test differently. Only 1 out of 41 patients had a 25 percent reduction of GFR but all patients had negative urine protein indicating the absence of renal injury. It is concluded that the risk of nephrotoxicity during the intensive phase of ATD treatment was minimal. This risk is not found to be dependent on the type of the dosage form given.
