Introduction:
Patients with chronic kidney disease (CKD) are at an increased risk of developing tuberculosis (TB). However, the efficacy and safety of anti-tubercular treatment (ATT) in this population remain unclear. In this study, we aim to evaluate the treatment success rate, mortality rate, and adverse events in patients with CKD receiving ATT.
Methods:
We conducted a systematic search through PubMed, Web of Science (WOS), and Scopus from inception till August 31st, 2024. We searched for all studies evaluating the efficacy and safety of ATT in patients with CKD. We used RevMan 5.4 software for the statistical analysis.
Results:
We included five observational studies in the meta-analysis, with a total sample size of 2,966 patients. The treatment success rate was 62.5% in the CKD group compared to 76.24% in patients with normal kidney function, showing a statistically significant difference (OR = 0.43; 95% CI [0.22, 0.84]; P = 0.01). The mortality rate was 19.97% in the CKD group versus 4.9% in patients with normal kidney function, with a statistically significant difference (OR = 3.40; 95% CI [2.20, 5.25]; P < 0.00001). Significant differences were also observed for drug-induced hepatitis (OR = 3.00; 95% CI [1.73, 5.19]; P < 0.0001), neurological and neuropsychiatric adverse events (OR = 3.98; 95% CI [0.99, 16.01]; P = 0.05), and gastrointestinal adverse events (OR = 3.52; 95% CI [1.76, 7.02]; P = 0.0004). However, no statistically significant differences were found for dermatological adverse events (OR = 0.76; 95% CI [0.32, 1.79]; P = 0.53) or arthritis (OR = 0.73; 95% CI [0.13, 4.01]; P = 0.72).
Conclusions:
Patients with CKD receiving ATT have a lower treatment success rate and a higher risk of mortality. They are also more prone to developing drug-induced hepatitis, neurological and neuropsychiatric, and gastrointestinal adverse events. Clinical trials to evaluate the optimal ATT regimen and appropriate dose adjustments for patients with CKD are recommended.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.