Evidence map›Paper›PMID 42671774›Full record

ArticleInfection2026

Effect of kidney function on drug concentrations of first-line anti-tubercular treatment.

Divya Datta, Indu Ramachandra Rao, Raghavendra Shetty, Shankar Prasad Nagaraju, Girish Thunga, Rahul Magazine, Shivashankara Kaniyoor Nagri, Nisha Abdul Khader, Pasumarthi Tejashree, Surulivelrajan Mallayasamy and 5 more

Abstract read
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In one paragraph

Article in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Divya DattaDepartment of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Indu Ramachandra RaoDepartment of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Raghavendra ShettyNavitas Life Sciences Pvt. Ltd, Manipal, 576104, Karnataka, India.
Shankar Prasad NagarajuDepartment of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Girish ThungaDepartment of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India.
Rahul MagazineDepartment of Respiratory Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Shivashankara Kaniyoor NagriDepartment of Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Nisha Abdul KhaderDepartment of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Pasumarthi TejashreeDepartment of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India.
Surulivelrajan MallayasamyDepartment of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India.
Praveen Kumar TirlangiDepartment of Infectious Disease, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Dharshan RangaswamyDepartment of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Srinivas Vinayak ShenoyDepartment of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Mohan V BhojarajaDepartment of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Attur Ravindra PrabhuDepartment of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India. ravindra.prabhu@manipal.edu.ORCID http://orcid.org/0000-0002-5980-7197

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTuberculosis (TB) and chronic kidney disease (CKD) are interconnected global health concerns. CKD patients have a higher risk of developing TB. Decreased clearance of drugs in kidney disease enhances toxicity risk. Current guidance on medication doses is not based on therapeutic drug monitoring. We measured and compared the concentrations of first-line anti-TB drugs in CKD and those with normal kidney function.

methodsA prospective observational study was conducted from September 2020 to December 2023. Patients with microbiologically confirmed tuberculosis were included, and drug concentrations were determined by using Liquid Chromatography-Tandem Mass Spectrometer (LC-MS/MS) and compared between CKD and those with normal kidney function.

resultsOf 151 participants, 51 had CKD. Higher trough concentrations were found in CKD for isoniazid [697.15 ng/mL (IQR 199.07-3321.68) vs. 187.58 ng/mL (IQR 95.56-323.65), P < 0.0001], rifampicin [141.53 ng/mL (IQR 40.86-730.66) vs. 33.24 ng/mL (IQR 22.49-86.20), P < 0.0001], and ethambutol [635.67 ng/mL (IQR 264.38-1594.12) vs. 230.92 ng/mL (IQR 161.95-417.22), P < 0.0001], while pyrazinamide level [1469.79 ng/mL (IQR 0.00-5160.53) vs. 4273.94 ng/mL (IQR 2151.29-8023.81), P = 0.002] was higher in those with normal kidney function. At 2-hours, a greater number of CKD patients had below the reference threshold for rifampicin [33/51 (64.7%) vs. 48/100 (48%), P = 0.059] and pyrazinamide [39/40 (97.5%) vs. 29/91 (31.8%), P < 0.0001].

conclusionCKD affects anti-tubercular drug concentrations, highlighting the need for therapeutic drug monitoring. CLINICAL TRIAL REGISTRATION NUMBER: CTRI/2020/09/027951.

Indexed as

Chronic kidney diseaseDrug concentrationFirst-line anti-tubercular drugsPharmacokineticsTuberculosis

Identifiers

PMID42671774

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.