The Clinical Features And Risk Factors For AntiTB Drug-induced Liver And Kidney Injury In Hunan Province

Objectives To understand the incidence and clinical characteristics of anti-tuberculosis drug-induced liver and kidney damage of patients with pulmonary tuberculosis in Hunan, and to analyze the risk factors of anti-tuberculosis drug-induced liver and kidney damage, for raising awareness of it as well as improving prevention of it.Methods This study is a historical cohort study. The Hunan Institution of Tuberculosis Control and Prevention (Hunan Chest Hospital) were selected as the study site. The medical records of600cases received standard antituberculosis regimen of TB patients were analyzed by retrospective study to understand the incidence of anti-tuberculosis drug-induced liver and kidney damage, to analyze its main clinical manifestations and laboratory results by descriptive analysis, and to explore the risk factors of it by Logistic regression analysis.Results Among600cases of the survey,117cases had liver damage, which accounts for19.5%,58cases had renal dysfunction, which accounts for9.67%. Main clinical manifestations of anti-tuberculosis drug-induced liver damage were nausea, vomiting, loss of appetite. Most early laboratory results were changes in the liver enzyme, while there is little change of serum bilirubin and protein content. Logistic univariate analysis showed that age, sex, HBSAg+, biliary tract disease, alcohol consumption, BMI, the basic level of ALT were all important risk factors. Multivariate analysis showed that HBSAg+, drinking, BMI, age were its independent risk factors. The main clinical manifestations of anti-tuberculosis drug-induced renal damage were flu-like symptoms and allergy-related symptoms. Most early laboratory results were changes of blood uric acid. Logistic univariate analysis showed that age, occupation, hypertension, diabetes, BMI and basic level of BUA were important risk factors. Multivariate results show that high blood pressure, diabetes, and high basic level of uric acid were an independent risk factor. Conclusions Compared to kidney damage, the incidence of liver damage of tuberculosis patients in Hunan during treatment is higher. HBSAg+, alcohol consumption, BMI, age are the main risk factors for liver damage of them. Hypertension, diabetes, and high basic level of uric acid are the main risk factors of renal damage of them.9tables,51references...