there is a difference in several references about the "normal" renal function, with no need to modify doses and the way to calculate doses in a case of chronic renal failure
The dose of Ethambutol is 15 mg / kg in patients with normal renal function . it should be reduced to 5 mg / kg in patients with CKD . This is because of ocular toxicity of ethambutol causing blindness .
ethambutol daily dose per kg is modified according to the severity of renal failure. to each severity grade, there is a recommended dose.
In our TB patients receiving dialysis, we continue with rifampicin and INH at normal daily doses; however, ethambutol and pyrizinamide are either dosed at normal doses Mondays, Wednesdays and Fridays (25mg/kg) or reduced doses (half the normal daily dose) daily. PZA should be dosed after dialysis since a significant concentration is removed during dialysis.
https://www.atsjournals.org/doi/full/10.1164/ajrccm.159.5.9810034
@dr yazied chothia: in the paper you mentioned, it's said that drugs are to be taken 2 hours before dialysis. so, patients could always eat during dialysis? do you do the same administration protocol, or do you keep them fasting during dialysis?
In our unit, we generally dose all antibiotics post-dialysis in order to keep nursing uniform. As in most dialysis units, our patients always have something to eat during dialysis (despite being advised to the contrary).
Ethambutol is administered on alternate days for patients on dialysis. In fact this dosage regimen is applicable to patients with GFR 60 ml/min/1,73M2