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<p>Acute kidney injury (AKI) is an uncommon but clinically significant complication of antituberculosis therapy (ATT). Although most reported cases occur in adults, adolescents may also be affected. We report a 15-year-old boy with sputum-positive pulmonary tuberculosis who developed severe AKI approximately two months after initiation of standard weight-based ATT (isoniazid, rifampicin, pyrazinamide, and ethambutol). He presented with fever, generalized edema, oliguria, vomiting, and dyspnoea. Laboratory evaluation revealed marked eosinophilia, severe renal dysfunction, and albuminuria. Alternative causes of AKI were excluded, and an ATT-induced immune-mediated acute interstitial nephritis was suspected. All ATT drugs were stopped, and oral prednisolone (≈ 1&#xa0;mg/kg/day) was initiated. The patient developed anuria and uraemic encephalopathy requiring urgent hemodialysis. Renal function and urine output improved significantly following initiation of hemodialysis and corticosteroid therapy. Kidney biopsy was deferred due to clinical instability. This case highlights the importance of early recognition of ATT-induced AKI, prompt drug withdrawal, and timely supportive therapy. Routine renal monitoring during ATT should be considered even in younger patients.</p>

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Acute kidney injury associated with antituberculosis therapy in an adolescent

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Anurag Sharma,
  • Hemant Sharma,
  • Dilip Kumar Gupta,
  • Vivek Singh

摘要

Acute kidney injury (AKI) is an uncommon but clinically significant complication of antituberculosis therapy (ATT). Although most reported cases occur in adults, adolescents may also be affected. We report a 15-year-old boy with sputum-positive pulmonary tuberculosis who developed severe AKI approximately two months after initiation of standard weight-based ATT (isoniazid, rifampicin, pyrazinamide, and ethambutol). He presented with fever, generalized edema, oliguria, vomiting, and dyspnoea. Laboratory evaluation revealed marked eosinophilia, severe renal dysfunction, and albuminuria. Alternative causes of AKI were excluded, and an ATT-induced immune-mediated acute interstitial nephritis was suspected. All ATT drugs were stopped, and oral prednisolone (≈ 1 mg/kg/day) was initiated. The patient developed anuria and uraemic encephalopathy requiring urgent hemodialysis. Renal function and urine output improved significantly following initiation of hemodialysis and corticosteroid therapy. Kidney biopsy was deferred due to clinical instability. This case highlights the importance of early recognition of ATT-induced AKI, prompt drug withdrawal, and timely supportive therapy. Routine renal monitoring during ATT should be considered even in younger patients.