Acute renal failure due to continuous rifampicin therapy

Rifampicin is one of the standart drugs of tuberculosis treatment. Acute renal failure (ARF) rarely may develop due to rifampicin. ARF, typically, develops on reintroduction of the drug or during intermittent therapy. However, it also has been reported during continuous rifampicin therapy. ARF that has developed during the four-drug tuberculosis regimen, given for sputum positive lung tuberculosis, including streptomycin 1 gr/day and rifampicin 600 mgr/day, has been evaluated at this study. Although streptomycin was stopped since the patient that had mildly high levels of urea and creatinine since the begining, a renal biopsy was performed. Histopathologic examination demonstrated an tubulointerstitial nephritis. Rifampicin was continued at the beginning, because tuberculosis disease of the patient was severe and the patient was not considered to have rifampicin toxicity. Since rifampicin toxicity is seen rarely in continuous therapy and we did not detect any objective way of immunoallergic damage the renal toxicity could not be related to rifampicin. We decided that it was a renal failure caused by rifampicin, according to the biopsy result. The patient had normal renal functions after discontinuation of rifampicin.