[Post-rifampicin acute renal failure--serious, but seldom recognized complication of the anti-tuberculosis treatment]. / Insuficienta renala acuta post-rifampicina--complicatie redutabila, însa putin cunoscuta a tratamentului tuberculostatic.

Post-rifampicin (RMP) acute renal failure (ARF) is a complication seldom recognized of the antiTB treatment worldwide. The renal failure which occurs especially after intermittent administration of RMP is most frequent due to acute interstitial nephritis by allergic mechanism. In our study we found very few cases of acute tubular necrosis or glomerular lesions revealed by rapidly progressive glomerulo-nephritis or nephrotic syndrome. The renal lesions, accompanied by anuria and usually needing hemodialysis, were associated to auto-immune hemolytic anemia, trombocytopenia, hepatic failure and gastro-intestinal disturbances. The authors review their experience (60 cases), representing about half of the cases published worldwide. The main causes of this high prevalence of post-RMP ARF in Romania are discussed: intermittent twice-a-week RMP treatment, high incidence of TB, lack of compliance to treatment, possible contribution of some by-substances in RMP capsule. We described the clinic, biology and evolution of this dangerous and underestimated entity. We compared our experience with the published data, discussing the etiology and pathogenesis, trying to design the fine portrait of this ailment.