OBJECTIVES: The aim of this study was to determine the effect of antituberculous drugs on serum uric acid (SUA), urine uric acid (UUA) excretion, and renal function. METHODS: Patients with tuberculosis requiring a 6-month treatment course of antituberculous drugs (isoniazid, rifampicin, pyrazinamide, and ethambutol for 2 months, followed by isoniazid and rifampicin for a further 4 months) were included in this study. Serum uric acid, 24-hour UUA excretion, uric acid clearance (UACl), serum creatinine, and creatinine clearance were determined at baseline and at the end of the second week, second month, and fourth month. RESULTS: Sixteen of 50 patients completed the study. Their mean ± SD baseline SUA and UACl was 4.44 ± 1.72 mg/dL and 8.77 ± 7.03 mL/min per 1.73 m, respectively. At the second week, a significant increase in SUA (9.78 ± 3.21 mg/dL, P < 0.001) and significant decrease in UACl (3.50 ± 2.50 mL/min per 1.73 m, P = 0.001) were noted. These changes persisted through the second month, but returned to baseline value at the fourth month. Thirteen patients (81.25%) had hyperuricemia. The 24-hour UUA followed the same pattern as that of UACl but showed no statistical significance. There were no changes in serum creatinine or creatinine clearance. One patient had arthralgia, and another developed tuberculous arthritis. CONCLUSIONS: The hyperuricemic effect of pyrazinamide and ethambutol was due primarily to a decrease in UACl, which was reversible, and had no negative effect on the renal function. Arthralgia was uncommon and required no specific treatment.
OBJECTIVES: The aim of this study was to determine the effect of antituberculous drugs on serum uric acid (SUA), urine uric acid (UUA) excretion, and renal function. METHODS:Patients with tuberculosis requiring a 6-month treatment course of antituberculous drugs (isoniazid, rifampicin, pyrazinamide, and ethambutol for 2 months, followed by isoniazid and rifampicin for a further 4 months) were included in this study. Serum uric acid, 24-hour UUA excretion, uric acid clearance (UACl), serum creatinine, and creatinine clearance were determined at baseline and at the end of the second week, second month, and fourth month. RESULTS: Sixteen of 50 patients completed the study. Their mean ± SD baseline SUA and UACl was 4.44 ± 1.72 mg/dL and 8.77 ± 7.03 mL/min per 1.73 m, respectively. At the second week, a significant increase in SUA (9.78 ± 3.21 mg/dL, P < 0.001) and significant decrease in UACl (3.50 ± 2.50 mL/min per 1.73 m, P = 0.001) were noted. These changes persisted through the second month, but returned to baseline value at the fourth month. Thirteen patients (81.25%) had hyperuricemia. The 24-hour UUA followed the same pattern as that of UACl but showed no statistical significance. There were no changes in serum creatinine or creatinine clearance. One patient had arthralgia, and another developed tuberculous arthritis. CONCLUSIONS: The hyperuricemic effect of pyrazinamide and ethambutol was due primarily to a decrease in UACl, which was reversible, and had no negative effect on the renal function. Arthralgia was uncommon and required no specific treatment.
Authors: Catherine Wei Min Ong; Giovanni Battista Migliori; Mario Raviglione; Gavin MacGregor-Skinner; Giovanni Sotgiu; Jan-Willem Alffenaar; Simon Tiberi; Cornelia Adlhoch; Tonino Alonzi; Sophia Archuleta; Sergio Brusin; Emmanuelle Cambau; Maria Rosaria Capobianchi; Concetta Castilletti; Rosella Centis; Daniela M Cirillo; Lia D'Ambrosio; Giovanni Delogu; Susanna M R Esposito; Jose Figueroa; Jon S Friedland; Benjamin Choon Heng Ho; Giuseppe Ippolito; Mateja Jankovic; Hannah Yejin Kim; Senia Rosales Klintz; Csaba Ködmön; Eleonora Lalle; Yee Sin Leo; Chi-Chiu Leung; Anne-Grete Märtson; Mario Giovanni Melazzini; Saeid Najafi Fard; Pasi Penttinen; Linda Petrone; Elisa Petruccioli; Emanuele Pontali; Laura Saderi; Miguel Santin; Antonio Spanevello; Reinout van Crevel; Marieke J van der Werf; Dina Visca; Miguel Viveiros; Jean-Pierre Zellweger; Alimuddin Zumla; Delia Goletti Journal: Eur Respir J Date: 2020-10-01 Impact factor: 16.671