Bismuth Subcitrate Nephrotoxicity

Sarıkaya, Metin; Sevinç, Alper; Ulu, Ramazan; Ateş, Fehmi; Ari, Fahri

doi:10.1159/000054741

Cited by 16 publications

(5 citation statements)

References 3 publications

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“…If symptoms persist despite this strategy Bismuth subsalicylate could be considered, but availability is limited and use is limited by nephrotoxicity. 82 …”

Section: Refractory CCmentioning

confidence: 99%

Optimal management of collagenous colitis: a review

O’Toole¹

2016

CEG

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Collagenous colitis (CC) is an increasingly recognized cause of chronic inflammatory bowel disease characterized by watery non-bloody diarrhea. As a lesser studied inflammatory bowel disease, many aspects of the CC’s natural history are poorly understood. This review discusses strategies to optimally manage CC. The goal of therapy is to induce clinical remission, <3 stools a day or <1 watery stool a day with subsequent improved quality of life (QOL). Antidiarrheal can be used as monotherapy or with other medications to control diarrhea. Budesonide therapy has revolutionized treatment and is superior to prednisone, however, the treatment is associated with high-relapse rates and the management of refractory disease is challenging. Ongoing trials will address the safety and efficacy of low-dose maintenance therapy. For those with refractory disease, case reports and case series support the role of biologic agents. Diversion of the fecal stream normalizes colonic mucosal changes and ileostomy may be considered where anti-tumor necrosis factor (TNF)-α agents are contraindicated. Underlying celiac disease, bile salt diarrhea, and associated thyroid dysfunction should be ruled out. The author recommends smoking cessation as well as avoidance of nonsteroidal anti-inflammatories as well as other associated medications.

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“…If symptoms persist despite this strategy Bismuth subsalicylate could be considered, but availability is limited and use is limited by nephrotoxicity. 82 …”

Section: Refractory CCmentioning

confidence: 99%

Optimal management of collagenous colitis: a review

O’Toole¹

2016

CEG

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“…28,29 Nephrotoxicity has been considered as the major adverse effect of high-dose intake of CBS. 30,31 We provided data to substantiate that little or reversible renal damage following the intake of CBS (500 mg kg −1 ) + 3NAC (580 mg kg −1 ) for 4 consecutive days in mice as adjudged by the BUN and creatinine levels in a 28 day duration. Considering the emergence of SARS-COV-2 variants 32 and resistance to anti-SARS-CoV-2 agents, e.g.…”

Section: Discussionmentioning

confidence: 98%

Orally administered bismuth drug together with N-acetyl cysteine as a broad-spectrum anti-coronavirus cocktail therapy

et al. 2022

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“…Although bismuth is key drugs during eradication therapy, because bismuth is significantly eliminated during HD and is toxic in uremic patients, bismuth will be difficult to select at eradication therapy for HD or advanced CKD patients [40,41]. In fact, there was no clinical comparative studies (e.g., randomized control study and cohort study) to investigate efficacy of bismuthcontaining regimens for HD or advanced CKD patients.…”

Section: Challenges In Eradication Therapy For H Pylori Infection In ...mentioning

confidence: 99%

“…In addition, in the absence of individual susceptibility testing, the first-line recommended treatment in areas (or groups) of high (>15%) or unknown clarithromycin resistance is bismuth quadruple therapy (grade: B2, and agreement: 92%). However, as mentioned above, because bismuth is not an appropriate drug to use in patients receiving HD, we think that individualized eradication therapy based on antimicrobial susceptibility may be useful [40,41].…”

Section: Situation Of Eradication In General Population and Patients ...mentioning

confidence: 99%

Eradication Therapy for Helicobacter pylori Infection in Patients Receiving Hemodialysis: Review

Sahara,

Sugimoto,

Murata

et al. 2024

Helicobacter

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Patients receiving hemodialysis (HD) often develop gastrointestinal diseases. Recently, although in general population, clinical guidelines for Helicobacter pylori have strongly recommended its eradication in patients to prevent gastric cancer, optimal eradication regimen and optimal dosage of drugs for patients receiving HD have not been established, due to possible incidence of adverse events. Some antimicrobial agents used in eradication therapy, particularly amoxicillin, can exacerbate renal dysfunction. Given the delayed pharmacokinetics of drugs in patients receiving HD compared with those in healthy individuals, drug regimen and dosage should be considered to minimize adverse effects. Although previous studies have investigated the benefits of eradication therapy for patients receiving HD, because most studies were small in terms of the number of enrolled patients, it is hard to show evidence. The numbers of eradication in HD patients have recently increased, and it is important to provide an optimal regimen. The consideration of eradication in patients undergoing HD with a reduction in the drug dose by 1/2–1/3 may prevent adverse events. Additionally, another important consideration is whether adverse events can be prevented while maintaining a similar eradication rate with reduced drug dosages. Recent meta‐analysis findings indicate comparable eradication rates in patients receiving HD and healthy individuals, both with the same dosage regimen and at a reduced dosage regimen, with no significant differences (relative risk [RR] for successful eradication: 0.85 [95% confidence interval (CI): 0.48–1.50]). Unlike with the same dosage regimen (RR for adverse events: 3.15 [95% CI: 1.93–5.13]), the adverse events in the dosage reduction regimen were similar to those in healthy individuals (RR: 1.26 [95% CI: 0.23–6.99]). From a pharmacological perspective, the eradication regimen in patients receiving HD should consider the dosage (1/2–1/3 dosage), dosing number (bid), dosing timing of drugs (after HD), and susceptibility to antimicrobial agents.

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Bismuth Subcitrate Nephrotoxicity

Cited by 16 publications

References 3 publications

Optimal management of collagenous colitis: a review

Optimal management of collagenous colitis: a review

Orally administered bismuth drug together with N-acetyl cysteine as a broad-spectrum anti-coronavirus cocktail therapy

Eradication Therapy for Helicobacter pylori Infection in Patients Receiving Hemodialysis: Review

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