Table 1.
Characteristics of M/XDR-TB patients stratified by AKI (n = 147)
| Nephrotoxicity (AKI) | Ototoxicity | ||||
|---|---|---|---|---|---|
| Variable | Total n (%) |
Yes (n = 80, 54%) n (%) |
No (n = 67, 46%) n (%) |
Yes (n = 38, 26%) n (%) |
No (n = 109, 74%) n (%) |
| Demographics and behaviour | |||||
| Age, years, median (range) | 35.3 (17–73) | 40.2 (18–73) | 31.8 (17–72) | 50 (17–72) | 33 (17–72) |
| BMI, kg/m2, median (range) | 20.3 (14–35) | 20.5 (14–29) | 19.6 (14–35) | 21 (14–29) | 20 (14–35) |
| Male | 96 (65) | 50 (62) | 46 (69) | 28 (74) | 68 (62) |
| History of incarceration | 27 (18) | 11 (14) | 16 (24) | 3 (8) | 24 (22) |
| Tobacco user | 76 (52) | 34 (43) | 42 (63) | 20 (53) | 56 (51) |
| Alcohol user | 50 (34) | 26 (33) | 24 (36) | 13 (34) | 37 (34) |
| Injection drug user | 10 (7) | 5 (6) | 5 (7) | 1 (3) | 9 (8) |
| Comorbidities | |||||
| HIV | 4 (3) | 1 (1) | 3 (4) | 2 (5) | 2 (2) |
| Diabetes | 18 (12) | 13 (16) | 5 (7) | 5 (13) | 13 (12) |
| Hepatitis C | 29 (20) | 14 (18) | 15 (22) | 7 (18) | 22 (20) |
| Initial injectable drug | |||||
| Kanamycin | 130 (88) | 71 (89) | 59 (88) | 31 (82) | 99 (91) |
| Capreomycin | 17 (12) | 9 (11) | 8 (12) | 7 (18) | 10 (9) |
| Clinical characteristics | |||||
| History of TB | 56 (38) | 28 (35) | 28 (42) | 15 (39) | 41 (38) |
| History of MDR-TB | 23 (16) | 8 (10) | 15 (22) | 6 (16) | 17 (16) |
| Cavitary disease | 26 (18) | 12 (15) | 14 (21) | 6 (16) | 20 (18) |
| Treatment follow-up | |||||
| Number of serum Cr measurements, median (range) | 14 (2–21) | 15 (3–21) | 10 (2–21) | 15.5 (5–21) | 13 (2–21) |
| Baseline CrCl, median (range) | 95 (45–236) | 97 (46–236) | 90 (45–165) | 76 (45–127) | 101 (49–236) |
| Baseline CrCl < 60 μmol/l | 14 (9) | 6 (8) | 8 (12) | 9 (24) | 5 (5) |
| Any abnormal K follow-up | 31 (21) | 22 (28) | 9 (13) | 8 (21) | 23 (21) |
| Hyperkalemia (maximum observed K > 5.5 mmol/l | 23 (16) | 17 (21) | 6 (9) | 7 (18) | 16 (15) |
| Time to first culture conversion, days, median (range)* | 95.5 (37–505) | 82 (37–352) | 100.5 (39–505) | 103 (37–268) | 78 (38–505) |
| Time in hospital (first hospitalization), days, median (range) | 65 (11–302) | 72 (12–302) | 52 (11–207) | 81.5 (33–302) | 52 (11–275) |
| Follow-up period, median (range) | 612 (28–1054) | 640 (81–1054) | 540 (28–1028) | 669 (102–1054) | 606 (28–1039) |
| Treatment regimen change | 135 (92) | 80 (54) | 55 (37) | 37 (97) | 98 (90) |
| Number of regimen changes, median (range) | 3 (0–9) | 3 (1–9) | 2 (0–8) | 4 (0–9) | 2 (0–8) |
| Treatment outcomes | |||||
| Cured | 26 (19) | 15 (20) | 11 (18) | 9 (24) | 17 (17) |
| Completed | 46 (34) | 31 (41) | 15 (25) | 16 (43) | 30 (30) |
| Failure | 2 (1) | 1 (1) | 1 (2) | 1 (3) | 1 (1) |
| Lost to follow-up | 51 (38) | 24 (32) | 27 (44) | 10 (27) | 41 (41) |
| Died | 7 (5) | 1 (1) | 6 (10) | 1 (3) | 6 (6) |
| Transferred out† | 4 (3) | 3 (4) | 1 (2) | 0 | 4 (4) |
*
Excluding LTFU, died and transferred out patients.
†
Patients who left the country for further treatment abroad.
MDR/XDR-TB = multidrug-resistant and extensivelydrug-resistant tuberculosis; AKI = acute kidney injury (RIFLE classification); BMI = bodymass index; HIV=human immunodeficiency virus; Cr = creatinine; CrCl = creatinine clearance; K = potassium; LTFU = loss to follow-up; RIFLE = Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease.