How does pyrazinamide cause renal toxicity in an adult patient on dialysis?

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Mechanism of Pyrazinamide-Induced Renal Toxicity

Pyrazinamide causes renal toxicity primarily through inhibition of renal tubular uric acid secretion, leading to hyperuricemia and, rarely, tubulointerstitial nephritis, though the latter mechanism remains poorly understood. 1

Primary Mechanism: Inhibition of Uric Acid Excretion

Pyrazinamide's most common renal effect involves disruption of normal uric acid handling in the kidney:

  • The drug inhibits renal tubular secretion of uric acid, resulting in decreased uric acid clearance and subsequent hyperuricemia in 81-84% of patients. 1, 2

  • Studies demonstrate that pyrazinamide suppresses the uric acid clearance to creatinine clearance ratio (Cua/Ccr) to as low as 2.3%, indicating near-complete blockade of tubular uric acid secretion. 3

  • This effect manifests within 2 weeks of treatment initiation, with serum uric acid rising from baseline levels of approximately 4.4 mg/dL to 9.8 mg/dL, while uric acid clearance drops from 8.8 mL/min to 3.5 mL/min per 1.73 m². 2

  • The hyperuricemic effect is reversible, returning to baseline values within 2 months after pyrazinamide discontinuation, with no permanent impairment of renal function (serum creatinine and creatinine clearance remain unchanged). 2

Rare Mechanism: Tubulointerstitial Nephritis

A second, uncommon mechanism involves direct tubular injury:

  • Pyrazinamide can cause acute tubulointerstitial nephritis, though this is rare and the exact pathophysiologic mechanism remains unclear. 4

  • Case reports document renal failure with fever, arthritis, and arthralgia during pyrazinamide therapy, with renal biopsy confirming tubulointerstitial nephritis that improved upon drug withdrawal while continuing other antituberculous agents. 4

  • This suggests an idiosyncratic or hypersensitivity reaction rather than a dose-dependent toxic effect. 4

Clinical Implications in Dialysis Patients

For patients already on dialysis, the renal toxicity concerns are modified:

  • The FDA label notes that only 17% of pyrazinamide is excreted via the kidneys, suggesting that renal impairment may not dramatically alter drug disposition, though clinical significance in end-stage renal disease remains uncertain. 5

  • Guidelines recommend reducing pyrazinamide dosing to 25-35 mg/kg three times weekly (not daily) for creatinine clearance <30 mL/min, though this applies to patients with residual renal function rather than those on dialysis. 6

  • Patients on dialysis do not require dose reduction for hyperuricemia prevention since they lack functional renal tubular secretion mechanisms, though monitoring for the rare tubulointerstitial nephritis remains prudent. 1

Important Caveats

  • The hyperuricemic effect, while common, is not considered true "renal toxicity" by most guidelines, as it represents an expected pharmacologic effect without adverse clinical consequences in the absence of symptomatic gout. 6, 7

  • Pre-existing gout is a contraindication to pyrazinamide use, as acute gouty arthritis can be precipitated in these patients. 5, 6

  • Asymptomatic hyperuricemia does not require treatment or drug discontinuation. 6, 7

References

Research

Effect of Antituberculous Drugs on Serum Uric Acid and Urine Uric Acid Excretion.

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2015

Research

Tubulointerstitial nephritis associated with pyrazinamide.

The Netherlands journal of medicine, 1989

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Management of Hyperuricemia in Anti-TB Medication

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Management of Hyperuricemia in Anti-Tuberculosis Treatment

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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