Ethambutol Effect on Renal and Hepatic Tissue Changes: A Literature Review

Abstract

Background: Ethambutol is an oral chemotherapeutic drug specifically effective against the active growth of microorganisms of the genus Mycobacterium. Ethambutol is generally well-tolerated and rarely causes side effects. One of the commonly known side effects of ethambutol is optic neuritis, some others include peripheral neuropathy, numbness and tingling, hepatotoxicity, mental disorders, disorientation, hallucinations, to psychosis. Purpose: This review aims to explain current and previous opinions about ethambutol use and its effects on kidney and liver tissue. The results of this review are expected to provide an overview of the impact of using ethambutol caused tissue damage in humans. Methods: In this literature review, we performed a search for several keywords such as "ethambutol", "renal tissue", and "hepatic tissue” on PubMed, Science Direct, and Google Scholar databases from January 2010 to January 2022. Results: Combination antituberculosis therapy intervention of isoniazid, rifampin, pyrazinamide, and ethambutol causes elevated liver enzymes and drug-induced liver injury. Studies reported 14 of 634 (2%) patients on ethambutol are at risk for DILI. Antituberculosis medications have also been reported to affect the kidneys because of their association with the liver as part of the excretory system. Therefore, the kidneys are exposed to the harmful effects of intermediate or waste metabolism leading to injury in these cases. Conclusion: Ethambutol has not been shown to significantly cause damage to liver and kidney tissue, but it has been reported to have an impact on elevated liver enzymes and renal impairment supported by histological findings. Keywords: Ethambutol, renal tissue, hepatic tissue.