International Urology and Nephrology

, Volume 34, Issue 4, pp 551–553 | Cite as

Tuberculosis in renal transplant recipients: Rifampicin sparing treatment protocol

  • Tushar J. VachharajaniEmail author
  • Umesh G. Oza
  • Ajit G. Phadke
  • Ashok L. Kirpalani


The reactivation of mycobacterium infection inrenal transplant recipients in developingcountries is a common therapeutic dilemma,especially in those patients receivingcyclosporin immunosuppression. The inclusion ofrifampicin in the antituberculosis protocolincreases the risk of precipitating acuteallograft rejection due to its interaction withcyclosporin and also increases the financialburden. We successfully treated 16 patients whodeveloped mycobacterial infection post renaltransplant with a rifampicin sparingantituberculosis drug regimen. Pyrexia ofunknown origin was the most common manifestationobserved and a therapeutic trial withantituberculosis drugs is justified. De novodiabetes mellitus appears to be an added riskfactor and increases the susceptibility tomycobacterial infection.

Tuberculosis Renal transplantation Rifampicin sparing therapy Cyclosporine interaction 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Cohen J, Hopkin J, Kurtz J. Infectious complications after renal transplantation. In: Morris PJ, ed. Kidney transplantation Principles and Practice (3rd ed). W.B. Saunders Company, 1988: 533.Google Scholar
  2. 2.
    Sakhuja V, Jha V, Varma PP et al. The high incidence of tuberculosis among renal transplant recipients in India. Transplantation 1996; 61: 211–215.Google Scholar
  3. 3.
    Rubin RH, Wolfson JS, Cosomi AB, Tolkoff-Rubin NE. Infections in the renal transplant recipient. Am J Med 1981; 70(2): 405–411.Google Scholar
  4. 4.
    Fauci AS. Corticosteroids and circulating lymphocytes. Transplant Proc 1975; 7: 37–40.Google Scholar
  5. 5.
    McMillan MA. Clinical pharmacokinetics of cyclosporin. Pharmocol Ther 1989; 42: 135–156.Google Scholar
  6. 6.
    Udani PM. Tuberculosis. In: Shah JS, ed. API Textbook of Medicine (4th ed) Associations of Physicians of India, 1986: 1091.Google Scholar
  7. 7.
    Naqvi A, Akhtar F, Naqvi R et al. Problems of diagnosis and treatment of tuberculosis following renal transplantation. Transplant Proc 1997; 29: 3051–3052.Google Scholar
  8. 8.
    Cengiz K. Increased incidence of tuberculosis in patients undergoing hemodialysis. Nephron 1996; 73: 421–424.Google Scholar
  9. 9.
    Spence RK, Dafoe DC, Rabin G et al. Mycobacterial infections in renal allograft recipients. Arch Surg, 1983; 118(3): 356–359.Google Scholar
  10. 10.
    Qunibi WY, Al-Sibai MB, Taher S et al. Mycobacterial infection after renal transplantation-report of 14 cases and review of the literature. Q J Med 1990; 77(282): 1039–1060.Google Scholar
  11. 11.
    Lloveras J, Peterson PK, Simmons PL, Najarian JS. Mycobacterial infections in renal transplant recipients. Seven cases and review of the literature. Arch Intern Med 1982; 142: 888–892.Google Scholar
  12. 12.
    Ascher NL, Simmons RL, Marker S et al. Tubrculous joint disease in renal transplant patients. Am J Surg 1978; 135(6): 853–856.Google Scholar
  13. 13.
    Al-Sulaiman MH, Dhar JM, Al-Khader. Transplantation 1990; 50(4): 597–598.Google Scholar

Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • Tushar J. Vachharajani
    • 1
    • 2
    Email author
  • Umesh G. Oza
    • 1
  • Ajit G. Phadke
    • 1
  • Ashok L. Kirpalani
    • 1
  1. 1.Department of TransplantationBombay Hospital Institute of Medical SciencesMumbaiIndia
  2. 2.Department of NephrologyLouisiana State University Health Sciences CenterShreveportUSA

Personalised recommendations