Ethambutol and Acute Kidney Injury

Risk Factors and Prevention

• Pre-existing renal insufficiency significantly increases the risk of ethambutol nephrotoxicity 1
• Higher doses (>30 mg/kg/day) of ethambutol increase the risk of all toxicities, including renal effects 1
• Renal function should be monitored regularly during ethambutol therapy, especially in patients with pre-existing renal impairment 1
• Ethambutol dosage must be adjusted in patients with renal insufficiency to prevent accumulation and toxicity 1
• For patients with end-stage renal disease, ethambutol should be administered at a dose of 15-20 mg/kg three times a week after dialysis 1

Clinical Presentation and Diagnosis

• AKI is diagnosed by a 50% or greater sustained increase in serum creatinine over a short period of time, reflected as a rapid decrease in eGFR 2
• People with diabetes are at higher risk of AKI than those without diabetes 2