POS-177 kidney impairment in patients with multidrug-resistant tuberculosis treated in pneumology department of Yalgado Ouédraogo University Hospital (Burkina Faso)

Abstract

In Burkina Faso, treatment of patients with multidrug-resistant tuberculosis included aminoglycosides until 2019. In 2020, a new protocol was adopted excluding aminoglycosides. Aminoglycosides are nephrotoxic and can lead to chronic kidney disease after (CKD) one or more acute kidney injury (AKI). in this study we report results of a cross-sectional study that identified kidney impairment in patients with multidrug-resistant tuberculosis (MDR-TB) treated with an aminoglycosides protocol. We reviewed the records of MDR-TB patients followed in pneumology department of Yalgado University Hospital between January 1, 2014 and December 31, 2019. Records of patients aged at least 18 years and having completed at least intensive phase of treatment were selected. and sociodemographic, clinical and biological information was collected. kidney impairment was defined by presence of AKI or CKD and/or Nephrotic Range Proteinuria (NRP). For each patient, we collected information from the beginning of the treatment until the last news (end of treatment, death or loss of fellow-up). Quantitative variables were expressed as mean ± standard deviation and qualitative variables as proportion. We found 147 files, including 41 incomplete files, and retained 106 complete files. Patients mean age was 38.3±12 years (Males: 36.6±11.6 years; Females: 42.9 ±11.8 years); sex ratio was 2.78. Hypertension and diabetes were present in one case each. kidney impairment was present in 35 cases (33%): 17 cases was AKI and CKD each; one case was NRP. AKI recovered completely in 5/17 cases. The mean eGFR of MDR-TB patients without kidney impairment and with kidney impairment was respectively 181.4 ± 230 mL/min/1.73 m² and 127.9 ± 56.8 mL/min/1.73 m² at M0. At M9, patients without kidney impairment and with kidney impairment respectively mean eGFR was 135.3 ± 73.2 mL/min/1.73 m² and 75.2 ± 26.1 mL/min/1.73 m².among those who had kidney impairment we had at the latest news: recovery of MDR TB : 29/35; discontinuation of follow-up: 2/35 deceased: 4/35. We found that treatment of MDR-TB with injectable aminoglycosides may be a cause of kidney disease; screening is routinely required for all patients who have been treated with these drug.