Adjusment Dosis pada Pengobatan Tuberculosis Paru Terkonfirmasi Bakteriologis dengan Gangguan Fungsi Ginjal: Case Report Study

Tri Tanayawati, Rika Yulia, Fauna Herawati, Januari Erik, Umi Fatmawati, Marisca Evalina Gondokesumo

Abstract

Pengobatan Tuberculosis (TB) secara signifikan mempengaruhi fungsi ginjal karena banyak obat TB diekskresikan melalui ginjal. Akibatnya, pada pasien dengan chronic kidney disease (CKD), dosis pemberian yang tidak tepat akan berujung pada kegagalan terapi atau meningkatnya efek samping. Laporan kasus ini bertujuan untuk mengevaluasi dampak penyesuaian dosis obat antituberkulosis (OAT), berbasis fungsi ginjal terhadap keamanan dan luaran klinis pada pasien TB dengan CKD stadium lanjut.  Seorang pasien sesak nafas selama 3 bulan terdiagnosis sebagai Tuberculosis (TB) paru terkonfirmasi bakteriologis yang sedang terapi antituberkulosis (OAT), Acute Kidney Injury (AKI) dd Acute on Chronic Kidney Disease (ACKD) mendapatkan terapi obat antituberkulosis (OAT) yang sudah dilakukan penyesuaian dosis berdasarkan nilai klirens kreatinin yaitu rifampisin 600 mg dan isoniazid 300 mg diberikan masing-masing tiap 24 jam. Pirazinamid 1250 mg dan etambutol 1000 mg diberikan 3x seminggu (senin, rabu, jumat. Hasil ini menunjukkan bahwa penyesuaian dosis berdasarkan fungsi ginjal untuk pasien CKD menghasilkan hasil yang baik dalam 11.0 mg/dL turun menjadi 8.3 mg/dL hal kemanjuran terapi yang serupa dengan pasien non-CKD. Penyesuaian dosis OAT berbasis fungsi ginjal meningkatkan keamanan terapi tanpa mengurangi efektivitas pengobatan. Pemantauan fungsi ginjal secara berkala direkomendasikan untuk mengoptimalkan luaran klinis dan mencegah toksisitas obat pada pasien tuberkulosis dengan CKD.

Keywords

Case report; Tuberculosis; Chronic Kidney Disease; Acute Kidney Injury; Acute on Chronic Kidney Disease

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DOI: https://doi.org/10.20961/jpscr.v11i1.87600

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