The following is a summary of “Glomerulonephritis during Mycobacterium tuberculosis infection: scoping review,” published in the August 2024 issue of Nephrology by Forster et al.
The relationship between tuberculosis (TB) infection and glomerulonephritis (GN) was unclear, including the spectrum of presentations, renal pathologies, clinical outcomes, clinical features, and immunosuppression in determining GN etiology.
Researchers conducted a retrospective study to search for all cases of TB infection and GN.
They searched for MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, and Conference Abstracts (as of December 2023). The study focused on patients with TB infection who developed GN and underwent renal biopsy. Data on patient presentation, characteristics, renal pathology, management of both TB and GN and outcomes were summarized.
The results showed 62 studies involving 130 patients; the cases presented varied, including acute kidney injury, nephrotic syndrome, and hypertension, with diagnoses spanning 10 different types of renal pathology, and outcomes varied from complete remission to long-term dialysis. Granulomas (4/4, 100%), anti-glomerular basement membrane disease (3/3, 100%), amyloidosis (75/76, 98.7%), and focal segmental glomerulosclerosis (2/2, 100%) were linked with TB-related GN. Minimal change disease was uniquely related to anti-TB therapy (7/7, 100%). Although immunosuppression was often prescribed for severe GN, efficacy could not be confirmed. Rifampin and isoniazid were the only drugs associated with drug-induced GN.
They concluded that the study justifies renal biopsy in patients with TB-GN, identified predictors of GN etiology, and established vital criteria for optimizing diagnosis and management.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03716-6
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