Trimethoprim-Sulfamethoxazole-Induced Renal Tubular Acidosis in a Patient with AIDS

Domingo, Peré; Ferrer, Santiago Estaún i; Cruz, Josefina; Morlà, Rosa; Ris, Josep

doi:10.1093/clinids/20.5.1435

Cited by 11 publications

(9 citation statements)

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“…Hyperchloremic non-anion gap metabolic acidosis was reported in an AIDS patient treated for pneumocystic carinii pneumonia with high dose intravenous SMX/TMP [26] which disagrees with findings in this work. This disagreement could be associated with differences in drug dose and route of administration.…”

Section: Discussioncontrasting

confidence: 99%

Renal Effect of Lopinavir/Ritonavir and Sulfamethoxazole/Trimethoprim in Albino Rats

Adikwu¹,

Geoffrey²,

Oputiri³

2014

AJPS

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Lopinavir/ritonavir and sulfamethoxazole/ trimethoprim have been individually associated with renal adverse events which could be characterized by electrolyte imbalance. The concurrent use of these drugs in the management of HIV and co infections may impair renal function; therefore this work evaluates the renal effect of the co administration of these drugs in rats. Seventy five (75) animals which were divided into five (5) groups were used in this study. Group A which served as control contained fifteen (15) animals which were treated with 1% ethanol orally. Group B-E which contained fifteen (15) animals each was further subdivided into three (3) subgroups of five (5) animals each. Animals in these groups were treated with oral doses of SMX/TMP (11.2/2.3mg/kg), LPV/r (11.4/2.9mg/kg) and combined doses of SMX/TMP + LPV/r for 2-8 weeks respectively. Serum levels of potassium, sodium and chloride were evaluated. Kidney tissues were evaluated for catalase (CAT), glutathione peroxidase (GSHP X ) and histopathological changes. Results showed that treatment with LPV/r, SMX/TMP and co administered SMX/TMP + LPV/r had no significant time dependent effect on serum potassium, sodium and chloride. Treatment with SMX/TMP produced time dependent decrease in kidney CAT and GSHP X while LPV/r had no significant effect on kidney CAT and GSHP X . No significant synergistic effects were observed on CAT and GSHP X level when these agents were co administered. Single and combined doses of these agents did not produce morphological changes in the kidney of treated animals. Conclusion: Concurrent use of LPV/r and SMX/TMP in the management of a HIV and co infection may not have deleterious effect on serum electrolytes and kidney structure.

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Section: Discussioncontrasting

confidence: 99%

Renal Effect of Lopinavir/Ritonavir and Sulfamethoxazole/Trimethoprim in Albino Rats

Adikwu¹,

Geoffrey²,

Oputiri³

2014

AJPS

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“…This may be related to the inhibitory effects of trimethoprim on sodium reabsorption in the cortical collecting tubules. Hyperchloremic non-anion gap metabolic acidosis was also reported in an AIDS patient treated for Pneumocystis carnii pneumonia with high-dose intravenous TMP/SMX (TMP 20 mg/kg/day)9).…”

Section: Trimethoprim/sulfamethoxazolementioning

confidence: 84%

“…Hyperkalemia itself may contribute to the development of acidosis through the effects on renal handling of ammonia and aldosterone secretion. The stimulation of aldosterone in this setting may attenuate the effects of TMP/SMX on handling of the hydrogen ion, therefore partially preventing acidosis9).…”

Section: Trimethoprim/sulfamethoxazolementioning

confidence: 99%

Antimicrobial-induced Electrolyte and Acid-Base Disturbances

Kim

2007

Electrolyte Blood Press

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Antimicrobials are one of the most widely prescribed classes of therapeutic agents. Although adverse effects of antimicrobials are generally minimal and reversible, serious sequelae can sometimes remain, such as unusual forms of renal failure, acid base disturbance and electrolyte abnormalities. Many antimicrobials, especially vancomycin or aminoglycosides, are associated with development of acute renal failure caused by acute tubular necrosis, allergic acute interstitial nephritis, or vasculitis. Besides, some antimicrobial agents can cause serious fluid and electrolyte imbalance. To prevent these serious consequences, early recognition and correction of their harmful renal and electrolyte effects are required.

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“…Rarely, corticosteroids have been reported to lead to an exacerbation of previously undiagnosed and untreated co-infections. In particular, fulminant courses of infections with Listeria monocytogenes, Mycobacterium tuberculosis and C. neoformans under treatment with corticosteroids have been reported [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Fatal Sepsis in an AIDS Patient during Therapy for Pneumocystis carinii Pneumonia

et al. 2002

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The case of a patient with a newly diagnosed HIV infection and Pneumocystis carinii pneumonia is presented. Despite treatment with high-dose trimethoprim/sulfamethoxazole (TMP/SMX) and prednisone with initial improvement, the patient acutely deteriorated with severe acidosis and died on the 4th day of hospitalization. Cryptococcus neoformans grew the next day in broncheoalveolar lavage (BAL) and blood culture. As simultaneous presence of more than one opportunistic infection can occur in these patients, systematic workup for other common opportunistic infections must be performed.

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Trimethoprim-Sulfamethoxazole-Induced Renal Tubular Acidosis in a Patient with AIDS

Cited by 11 publications

References 0 publications

Renal Effect of Lopinavir/Ritonavir and Sulfamethoxazole/Trimethoprim in Albino Rats

Renal Effect of Lopinavir/Ritonavir and Sulfamethoxazole/Trimethoprim in Albino Rats

Antimicrobial-induced Electrolyte and Acid-Base Disturbances

Fatal Sepsis in an AIDS Patient during Therapy for Pneumocystis carinii Pneumonia

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