Nephrotoxicity Consideration in DR TB Patients Treated with Injectable Short Term Regimen (STR) with Prior Comorbidities

Rationale: Drug-resistance tuberculosis (DR TB) remains a huge problem in Indonesia. There are limited studies on short termregimen (STR) adverse events (AE) in Indonesia, particularly nephrotoxicity. Irreversible deterioration of renal function could befatal outcome. Injectable nephrotoxicity may be associated with electrolyte wasting. Patients with pre-existing kidney disease,diabetes, or HIV are at high risk of injectable nephrotoxicity. Our hospital implements injectable STR since 2016. Therefore, it isimportant to evaluate renal adverse events in each DR TB centre to improve patient management. Methods: This was alongitudinal cohort study among DR TB outpatients at Persahabatan Hospital who received STR from August 2019 to January2021. We evaluated renal AE based on electrolyte imbalance and creatinine clearance from patients’ monthly laboratoriesfindings. Grading adverse events severity using common terminology criteria for adverse events (CTCAE) version 5. Results: Atotal of 68 patients recruited, with median age 37 (18-69) years old, male dominants (67.6%) and partly have prior comorbidities(27.9%). Renal adverse events occurred in 61.8% patients, with median onset 34.5 days, and 16.7% had severe increased ofcreatinine clearance. Among the severe nephrotoxicity patients, 57.1% of which succeed their treatment. From the cohort trendgraph below, most patients treated with injectable STR will peaked renal AE after intensive phase and some patients will regainfrom nephrotoxicity in continuous phase. One of the success patients with prior comorbid, encountered numerous times ofrehospitalization due to severe electrolyte imbalance. Conclusion: Nephrotoxicity should be consideration for before givinginjectable STR to patients with prior comorbidities.This abstract is funded by: NoneAm J Respir Crit Care Med 2022;205:A1919Internet address: www.atsjournals.org Online Abstracts Issue