Clinical course of AKI
Among 11 patients with AKI, the time to AKI ranged from 6 to 68 days and
AKI duration ranged from 8 to 286 days (Table 3). Most AKI events were
classified as KDIGO stage 1, except for one patient who had stage 3 AKI.
After AKI onset, four patients continued with the previous anti-TB
regimen, six discontinued all anti-TB drugs, and one discontinued EMB.
Among six patients who discontinued RIF, four restarted full-dose RIF 2
to 8 weeks after discontinuation. In another patient, RIF was replaced
with rifabutin after 2 weeks of dissimulation. For the remaining one
patient, RIF was reintroduced at a dose of 150 mg daily and increased
150mg every 2 days to full dose.
Urinalysis revealed no overt pyuria or hematuria; however, two patients
exhibited mild proteinuria (1+; Table 3). The FENa value ranged from
0.2% to 2.9%, suggesting a prerenal AKI etiology in five (45%)
patients and a renal etiology in six (55%) patients. A renal echography
revealed an enlarged kidney in two patients, renal
stones in two patients, and renal atrophy in one patient. A
morphological analysis of red blood cells (RBCs) revealed the presence
of abnormal RBCs in 10 patients, with anisocytosis in eight and teardrop
cells, target cells, and fragmented RBCs in one patient each. All
patients recovered their renal function and completed the anti-TB
treatment. The laboratory findings revealed higher serum uric acid
(0.58±0.14 versus 0.30±0.12 mmol/L, p < 0.001) and
hemoglobin levels (135±20 versus 127±19 g/L, p = 0.034) at AKI
onset than at baseline (Table 2).