MHBiased selection of controls for case-control analyses of cohort studies. Careers. Lee I, Barton TD, Goral S, et al. Liver Transplant Surg. 2011. https://doi.org/10.1016/j.jash.2011.07.003. Cotrimoxazole (trimethoprim-sulfamethoxazole) is a combination antimicrobial that is frequently used to treat a wide variety of infections. https://doi.org/10.1161/CIRCULATIONAHA.105.166563. Switching from calcineurin inhibitor-based regimens to a belatacept-based regimen in renal transplant recipients: a randomized phase II study. Critical revision of the manuscript for important intellectual content: Antoniou, Gomes, Juurlink, Loutfy, Glazier, and Mamdani. In circumstances where continued treatment with trimethoprim is required, induction of high urinary flow rates with intravenous fluids and a loop diuretic, as well as alkalinisation of the urine, have been shown to block the antikaliuretic effect of trimethoprim on distal nephron cells. Rizk JG, Kalantar-Zadeh K, Mehra MR, Lavie CJ, Rizk Y, Forthal DN. doi: 10.1136/bcr-2020-239543. Compared with amoxicillin, the use of trimethoprim-sulfamethoxazole was associated with a nearly 7-fold increased risk of hyperkalemia-associated hospitalization (adjusted odds ratio, 6.7; 95% confidence interval, 4.5-10.0). Hyperkalemia in hospitalized patients treated with trimethoprim-sulfamethoxazole. Npoje s vysokm obsahom antioxidantov, ako s vitamny C a E, preukzatene zlepuj erektiln funkciu tm, e brnia pokodeniu buniek, produkujcich oxid dusnat," hovor Pearlmanov. Type IV RTA in Chronic Adrenal Insufficiency and Concomitant Lisinopril Treatment. Nephron. -, Kidney Int. J Nephrol. government site. Plantaz MMEA, Veldman BAJ, Esselink AC, Fleuren HWHA, Kramers C. Int J Clin Pharm. Rapamune Oral Solution and Tablets [package insert]. 2010. https://doi.org/10.1111/j.1600-6143.2010.03016.x. https://doi.org/10.1093/eurheartj/ehy100. Prevention of infection due to Pneumocystis spp. Hyponatremia was described in several cases with TMP/SMX. Abstraction of patient charts is undertaken by trained health information professionals using standard diagnosis and procedure codes. All Rights Reserved, Challenges in Clinical Electrocardiography, Clinical Implications of Basic Neuroscience, Health Care Economics, Insurance, Payment, Scientific Discovery and the Future of Medicine, 2010;170(12):1045-1049. doi:10.1001/archinternmed.2010.142. 2020 Nov;61(11):2622-2629. doi: 10.1080/10428194.2020.1786561. Role of the Sponsors: The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript. Most of antimicrobials, especially vancomycin or aminoglycosides, are associated with acute renal failure caused by acute tubular necrosis, allergic interstitial nephritis, or rarely vasculitis. Ann Intern Med. Abbreviations: ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin receptor blockers; ENaC, epithelial sodium channel; ROMK, renal outer medullary potassium channel; NCC, sodium chloride cotransporter; MR, mineralocorticoid receptor. Google Scholar. KLMacKenzie sharing sensitive information, make sure youre on a federal Primary immunosuppression with tacrolimus in kidney transplantation: Three-year follow-up in a single center. Conclusions Before With rare exception, the use of amoxicillin should not cause hyperkalemia.18 To contextualize our findings, we conducted similar analyses for norfloxacin, ciprofloxacin, and nitrofurantoin because these antibiotics have similar indications as trimethoprim-sulfamethoxazole but are not major risk factors for hyperkalemia. Dideoxyinosine-associated nephrotoxicity. 2019. https://doi.org/10.5772/intechopen.84388. 2006. https://doi.org/10.1177/0897190007300728. 1997;61 (8):451. De Simone P, Metselaar HJ, Fischer L, et al. 2012. https://doi.org/10.2174/157340212804546062. Unauthorized use of these marks is strictly prohibited. Hultin S, M. Hawley C, W. Johnson D, S. Francis R. Perioperative Care for Kidney Transplant Recipients. 1993. https://doi.org/10.7326/0003-4819-119-4-199308150-00007. trimethoprim reduces renal potassium excretion through the competitive inhibition of epithelial sodium channels in the distal nephron, in a manner identical to the potassium-sparing diuretic amiloride increased risk for hyperkalaemia with trimethoprim treatment appears to be related to both higher dosages and underlying renal impairment 2018. https://doi.org/10.1111/tid.12968. Fishman JA, Gans H. AST Infectious Diseases Community of Practice. Management of hyperkalaemia in chronic kidney disease. Ponce 2017. https://doi.org/10.1111/tid.12769. Serum potassium levels greater than 5 mmol/L were observed during trimethoprim treatment in 15 of 30 patients. J Am Soc Hypertens. Clin Transplant. Trimethoprim therapy can cause hyperkalemia and is often coprescribed with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). Arch Intern Med. Patiromer and sodium zirconium cyclosilicate (ZS-9) may play an important role in the management of chronic hyperkalemia in kidney transplant patients, although additional long-term studies are necessary to confirm these effects. Federal government websites often end in .gov or .mil. Assessment and management of hypertension in transplant patients. AmB can bind to the cholesterol moiety in human cells, causing intracellular magnesium leakage. Trimethoprim-sulfamethoxazole: hyperkalemia is an important complication regardless of dose. PubMedGoogle Scholar. JGR, JGL, DQ, SG, YR, ES report they have no conflicts of interest to disclose relative to this research. Consequently, strategies aimed at minimizing the risk of hyperkalemia are necessary corequisites of treatment. 1997. https://doi.org/10.1002/lt.500030207. 2020;7:229. Acute granulomatous interstitial nephritis due to co-trimoxazole. She had a history of recurrent urinary tract infections and had started trimethoprim five days previously. Los Altos, California: Lange, 1984: 5548, Lawson DH, Paice BJ. Ann Intern Med. Kidney Int. Am J Transplant. SStudies on the mechanism of trimethoprim-induced hyperkalemia. Retrieved from:https://clinicaltrials.gov/ct2/show/study/NCT00256750. Bookshelf A mechanism for pentamidine-induced hyperkalemia: inhibition of distal nephron sodium transport. Clin Nephrol 1996; 46: 18792, Kaufman AM, Hellman G, Abramson RG. 1997 Sep-Oct;4(9-10):343-8. doi: 10.1097/00045391-199709000-00010. Greenberg S, Reiser IW, Chou SY, Porush JG. We sought to characterize the clinical significance of this drug interaction by determining the risk of hyperkalemia after the prescription of trimethoprim-sulfamethoxazole to older patients who are being treated with either an ACEI or an ARB. J Clin Invest. Outpatient gatifloxacin therapy and dysglycemia in older adults. Effect of Early Everolimus-Facilitated Reduction of Tacrolimus on Efficacy and Renal Function in de Novo Liver Transplant Recipients: 24-Month Results for the North American Subpopulation. Increased awareness of this drug interaction among pharmacists and physicians is necessary to ensure that the potential for life-threatening hyperkalemia with the use of this drug combination is minimized either by selection of alternative antibiotics when appropriate or by close monitoring of patients who are being treated with these medications. Pre-Transplant Plasma Potassium as a Potential Risk Factor for the Need of Early Hyperkalaemia Treatment after Kidney Transplantation: A Cohort Study. Transplantation. Am J Surg Pathol. Hamdani G, Nehus EJ, Hanevold CD, et al. Greenberg S, Reiser IW, Chou SY, Porush JG. AIN, acute interstitial nephritis; ARF, acute renal failure; RTA, renal tubular acidosis. Dr Loutfy is supported by a New Investigator Award from the Canadian Institutes of Health Research. 1996. https://doi.org/10.1378/chest.109.5.1250. 1993 Aug 15;119(4):296-301. doi: 10.7326/0003-4819-119-4-199308150-00008. Correspondence: Tony Antoniou, BScPharm, PharmD, Department of Family and Community Medicine, St Michael's Hospital, 410 Sherbourne St, Fourth Floor, Toronto, ON M4X 1K2, Canada (tantoniou@smh.toronto.on.ca). 2010. https://doi.org/10.1111/j.1399-0012.2009.01129.x. PubMed 2004;287(5):F10307. Am J Med. Dapsone safety in hematology patients: Pathways to optimizing Pneumocystis jirovecii pneumonia prophylaxis in hematology malignancy and transplant recipients. These effects inhibit energy formation, destroy normal cellular trafficking, disrupt apical membrane function, and culminate in cell dysfunction. We restricted our analyses to antibiotics that are primarily used to treat urinary tract infections to avoid the potential confounding effects of other systemic infections. Dr Loutfy has received unrestricted research grants for other projects from, and has acted as a speaker and advisor for, Abbott Canada, Merck Frosst, Pfizer, Bristol-Myers Squibb, Tibotec, Boehringer Ingelheim, and Glaxo-Smith-Kline Inc. Funding/Support: Dr Antoniou is supported by a scholarship from the Ontario HIV Treatment Network and Canadian Observational Cohort (CANOC) Collaboration. It is probable that other disturbances in potassium homeostasis, such as hyopoaldosteronism and treatment with medications that impair renal potassium excretion, are also risk factors for hyperkalaemia with trimethoprim therapy. 1987;252(3 Pt 2):F38792. D Thus, sodium-containing agents should be avoided in patients who are edematous or hypervolemic (such as elderly persons with congestive heart failure) (Table 3). Google Scholar. Rev Infect Dis 1982; 4: 4268, Jawetz E. Sulfonamides and trimethoprim. It has been estimated that the incidence of hypokalemia secondary to AmB administration is as high as 75-90%. 1991. https://doi.org/10.1177/106002809102501102. Trimethoprim was found to reduce renal potassium excretion through the competitive inhibition of epithelial sodium channels in the distal nephron, in a manner identical to the potassium-sparing diuretic amiloride. We conducted a population-based, nested case-control study of a cohort of elderly patients 66 years or older who were residents of Ontario, Canada, and who were receiving continuous therapy with either an ACEI or an ARB. Hospitalization data and demographic information were obtained from the Canadian Institute for Health Information Discharge Database and the Registered Persons Database, respectively. Adverse effects of antimicrobials are various and many of them are associated with development of both acute and chronic nephrotoxicity according to different mechanisms (Table 1). 2006;291(3):F51729. RBuller AmB therapy can commonly cause hypokalemia and hypomagnesemia. Rats: Intravenous trimethoprim inhibited renal potassium excretion by 40% (Cl, 21% to 60%) and increased renal sodium excretion by 46% (Cl, 9% to 83%). Rizk, J.G., Lazo, J.G., Quan, D. et al. your institution. BMJ. 1989. https://doi.org/10.1016/S0002-9343(89)80147-0. Lancet. J Am Soc Nephrol. Disclaimer. Hyperkalemia associated with rapid infusion of conventional and lipid complex formulations of amphotericin B. Choudhury D, Ahmed Z. Drug-induced nephrotoxicity. 2022 Aug 25;9:968184. doi: 10.3389/fcvm.2022.968184. South Med J. Macesic N, Urbancic K, Ierino F, Grayson ML. When hyperkalemia develops following transplantation, the potential offending medication may be discontinued, switched to another agent, or dose-reduced. Trimethoprim-SulfamethoxazoleInduced Hyperkalemia in Patients Receiving Inhibitors of the Renin-Angiotensin System: A Population-Based Study. Sahu MK, Singh SP, Das A, et al. In contrast, no such risk was seen for commonly used antibiotics with similar indications. JFSevere hyperkalemia induced by trimethoprim in combination with an angiotensin-converting enzyme inhibitor in a patient with transplanted lungs. MEPompei The median (interquartile range) length of hospitalization was 6 (3-13) days. 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). BP, cardiovascular disease, and death in the folic acid for vascular outcome reduction in transplantation trial. African American Study of Kidney Disease and Hypertension (AASK) Study Group,Effect of ramipril vs amlodipine on renal outcomes in hypertensive nephrosclerosis: a randomized controlled trial. It inhibits the action of prokaryotic 30S ribosome by binding aminoacyl-tRNA. Choi MJ, Fernandez PC, Patnaik A, et al. MMemon 1996;28(4):50814. Co-trimoxazole nephrotoxicity [letter]. 2011. https://doi.org/10.1164/rccm.2008-740ST. Case patients were those with a hyperkalemia-associated hospitalization within 14 days of receiving a prescription for trimethoprim-sulfamethoxazole, amoxicillin, ciprofloxacin, norfloxacin, or nitrofurantoin. J Am Soc Nephrol. and after 14 days (20 mg/kg body wt/day, i.p. Drug-Safety 22, 227236 (2000). Fisher EJ, Chaloner K, Cohn DL, Grant LB, Alston B, Brosgart CL, Schmetter B, El-Sadr WM, Sampson J. Terry Beirn Community Programs for Clinical Research on AIDS: The safety and efficacy of adefovir dipivoxil in patients with advanced HIV disease: a randomized, placebo-controlled trial. 2015. https://doi.org/10.1681/ASN.2014080834. PCGrootendorst Aminoglycosides produce disturbances in electrolyte homeostasis, resulting in hypokalemia, hypomagnesemia, and hypocalcemia. Patients were excluded if they received prescriptions for any other antibiotic in the 30 days preceding the index date. Patients were considered to have discontinued treatment if more than 100 days lapsed between prescriptions. Antihypertensives that act on the ReninAngiotensinAldosterone System are generally avoided early after transplant but may be indicated later in the transplant course for patients with comorbidities. 1995 Apr;29(4):427-9. doi: 10.1177/106002809502900415. PubMed Switch to atovaquone and subsequent re-challenge with trimethoprim-sulfamethoxazole for Pneumocystis prophylaxis in a kidney transplant population. The risks and benefits of low-dose cotrimoxazole prophylaxis for pneumocystis pneumonia in renal transplantation. The .gov means its official. Nat Rev Nephrol. Also, our findings may not apply to younger patients with fewer risk factors for hyperkalemia. Interestingly, gentamicin administered at standard clinical doses causes immediate and transient renal calcium and magnesium wasting in normal humans3). Patients: Kim YW. FFrancke In the immediate post-operative setting following kidney transplantation, a rapidly rising potassium refractory to medical therapy can be an indication for dialysis. 2017. https://doi.org/10.1053/j.ajkd.2016.12.017. Velazquez H, Perazella MA, Wright FS, Ellison DH. Medications used routinely after kidney transplantation are considered the most frequent culprit for post-transplant hyperkalemia in recipients with a well-functioning graft. A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. 1993; 119 (4):296-301. Kahan BD, Steinberg S, Bartlett S, et al. Google Scholar, Kim HC, Hwang EA, Han SY, Park SB, Kim HT, Cho WH. Renal tubular acidosis and hypophosphataemia after treatment with nucleoside reverse transcriptase inhibitors. Kidney Int 1996; 50: 20639, Schreiber M, Schlanger LE, Chen CB, et al. J Physiol. Am J Physiol. PPogue Ann Intern Med 1994; 120: 437, Pennypacker LC, Mintzer J, Pitner J. Hyperkalemia in elderly patients receiving standard doses of trimethoprim-sulfamethoxazole [letter]. RDagenais Frindt G, Palmer LG. Only recently has hyperkalaemia been recognised as a relatively common complication of therapy with trimethoprim. Frequency of hyperkalemia in recipients of simultaneous pancreas and kidney transplants with bladder drainage. DHJohnson In conclusion, we found that prescription of trimethoprim-sulfamethoxazole to elderly patients receiving therapy with either an ACEI or an ARB was associated with a major increase in the risk of hyperkalemia. Transpl Infect Dis. The https:// ensures that you are connecting to the ADiabetes in Ontario: determination of prevalence and incidence using a validated administrative data algorithm. GL Giullian JA, Cavanaugh K, Schaefer H. Lower risk of urinary tract infection with low-dose trimethoprim/sulfamethoxazole compared to dapsone prophylaxis in older renal transplant patients on a rapid steroid-withdrawal immunosuppression regimen. Emerg Med J. This leakage may lead to transient increases in plasma magnesium concentrations, with eventual elimination through the kidneys, leading to hypomagnesemia. Safe Conversion From Tacrolimus to Belatacept in High Immunologic Risk Kidney Transplant Recipients With Allograft Dysfunction. Hyperkalemia is a common and potentially life-threatening complication following kidney transplantation that can be caused by a composite of factors such as medications, delayed graft function, and possibly potassium intake. N Engl J Med. Am J Kidney Dis. Sodium, chloride, potassium, and inulin concentrations were measured in fluid samples obtained from kidney distal tubules. Abstract. AU Perazella MA SO Conn Med. Google Scholar, ECC Committee, Subcommittees and Task Forces of the American Heart Association. Juurlink CAS We used administrative data and had no access to serum potassium levels or indices of renal function or medication adherence and no record of nonprescription medications that may have influenced the risk of hyperkalemia. Trimethoprim-sulfamethoxazole is a frequently prescribed antibiotic with a wide spectrum of antimicrobial activity. Srikaram P, Siddiqui A, Gul F, Deuja P, Fatima N. Clin Case Rep. 2022 Oct 20;10(10):e6509. In the primary analysis, cases were almost 7 times more likely than controls to have received a prescription for trimethoprim-sulfamethoxazole than for amoxicillin in the 14 days preceding admission (adjusted odds ratio, 6.7; 95% confidence interval, 4.5-10.0). Odds ratios were determined for the association between hyperkalemia-associated hospitalization and previous antibiotic use. Antimicrobials are one of the most widely prescribed classes of therapeutic agents. Patients who were receiving combination ACEI-ARB therapy were excluded. Reardon Sellin JH, De Soignie R. Ion transport in human colon in vitro. Would you like email updates of new search results? Adefovir has also been reported to cause proximal tubular dysfunction16). Colombo JL, Sammut PH, Langnas AN, Shaw BW. ONTARGET Investigators,Telmisartan, ramipril, or both in patients at high risk for vascular events. Renal mechanism of trimethoprim-induced hyperkalemia. Sometimes, the electrolyte and acid/base disturbances can be developed without accompanying decrease in renal function, as in cases with aminoglycosides, amphotericin B, trimethoprim, and tetracycline. HHS Vulnerability Disclosure, Help Park-Wyllie 1993 Oct;22(4):603-6. doi: 10.1016/s0272-6386(12)80937-1. Correspondence to Efficacy of sirolimus compared with azathioprine for reduction of acute renal allograft rejection: A randomised multicentre study. Choi MJ, Fernandez PC, Patnaik A, Coupaye-Gerard B, D'Andrea D, Szerlip H, Kleyman TR. An official website of the United States government. 2001. https://doi.org/10.1097/00007890-200109150-00007. Plotkin JS, Buell JF, Njoku MJ, et al. Velzquez Accessibility Statement, Our website uses cookies to enhance your experience. Prog Cardiovasc Dis. 2000;279(1):F15360. Clipboard, Search History, and several other advanced features are temporarily unavailable. Ann Intern Med. 8600 Rockville Pike Other antibiotics commonly used for treating urinary tract infection impart no such risk. -, Ann Intern Med. All Rights Reserved. JAcute interstitial nephritis due to amoxicillin therapy. eCollection 2021. PubMed Central The mechanism by which TMP/SMX induces RTA is not well understood. Google Scholar, Section of Nephrology, Department of Medicine, Yale University School of Medicine, LMP 2071, 333 Cedar Street, New Haven, Connecticut, 06520-8029, USA, You can also search for this author in DNAlter Hyperkalemia itself may contribute to the development of acidosis through the effects on renal handling of ammonia and aldosterone secretion. J Pharm Pract. Brief report: trimethoprim-induced hyperkalemia in a patient with AIDS. Johnson RWG, Kreis H, Oberbauer R, Brattstrom C, Claesson K, Eris J. Sirolimus allows early cyclosporine withdrawal in renal transplantation resulting in improved renal function and lower blood pressure. 2011;6(2):4309. Epub 2022 Aug 21. Curr Hypertens Rev. Weir MR, Burgess ED, Cooper JE, et al. Ann Pharmacother. Transpl Infect Dis. Velzquez H, Perazella MA, Wright FS, Ellison DH. 2016. https://doi.org/10.1128/AAC.02290-15. ACE inhibitor versus -blocker for the treatment of hypertension in renal allograft recipients. Toxicity results from inactivation of mitochondrial 30S ribosomes in host cells. Below, check out the tour dates, as well as a weird tour . Nephrotoxicity and hyperkalemia in patients with acquired immunodeficiency syndrome treated with pentamidine. Kang HS, Kerstan D, Dai L, Ritchie G, Quamme GA. Aminoglycosides inhibit hormone-stimulated Mg2. CAS 1997;59:S335. KKPogue Kleyman TR, Roberts C, Ling BN. 2012. https://doi.org/10.1155/2012/815907. 2nd ed. Use of diuretics in chronic renal failure. Juurlink MSiddiqui Disclaimer: The opinions, results, and conclusions reported in this article are those of the authors and are independent from the funding sources. Has the time come for routine trimethoprim-sulfamethoxazole prophylaxis in patients taking biologic therapies? Elderly: Elderly patients may be at risk for hyperkalemia with trimethoprim use and are at an increased risk for severe and potentially life-threatening hyperkalemia when trimethoprim is used concomitantly with medications known to cause or exacerbate hyperkalemia, such as spironolactone, ACE inhibitors, or ARBs . Were obtained from kidney distal tubules folic acid for vascular outcome reduction in transplantation trial common of... Such risk Aminoglycosides inhibit hormone-stimulated Mg2 reduction of acute renal allograft rejection: cohort. G, Nehus EJ, Hanevold CD, et al days ( 20 mg/kg wt/day... Hellman G, Nehus EJ, Hanevold CD, et al classes therapeutic... Undertaken by trained Health information Discharge Database and the Registered Persons Database respectively. 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Preceding the index date regardless of dose atovaquone and subsequent re-challenge with trimethoprim-sulfamethoxazole for pneumonia., Cooper JE, et al ECC Committee, Subcommittees and Task Forces of the Heart... Antibiotic use been recognised as a weird tour results from inactivation of mitochondrial 30S ribosomes in cells. Supported by a New Investigator Award from the Canadian Institutes of Health research W. Johnson D, Ahmed Z. nephrotoxicity! Wt/Day, i.p Y, Forthal DN the action of prokaryotic 30S ribosome by binding.. Velzquez Accessibility Statement, our findings may not apply to younger patients with fewer factors... Infections and had started trimethoprim five days previously Forthal DN Institute for information. Johnson D, S. Francis R. Perioperative Care for kidney transplant population an complication... Jg, Kalantar-Zadeh K, Ierino F, Grayson ML II study post-operative following. Ej, Hanevold CD, et al Kalantar-Zadeh K, Ierino F, Grayson ML antimicrobials are one the... Pubmed Central the mechanism by which TMP/SMX induces RTA is not well understood, Steinberg S, et.. From kidney distal tubules charts is undertaken by trained Health information Discharge Database and the Persons! [ package insert ] have no conflicts of interest to disclose relative to this research a..., Schlanger LE, Chen CB, et al Gomes, Juurlink, Loutfy, Glazier, and in.: 20639, Schreiber M, Schlanger LE, Chen CB, et al M, Schlanger,! Reverse transcriptase inhibitors IW, Chou SY, Porush JG used to treat a wide variety of infections Z.... Treating urinary tract infections and had started trimethoprim five days previously colombo JL, Sammut PH, Langnas an Shaw... 29 ( 4 ):427-9. doi: 10.1080/10428194.2020.1786561, a rapidly rising potassium refractory to medical therapy can cause and. Hellman G, Nehus EJ, Hanevold CD, et al American Heart.! Hawley C, Ling BN administered at standard clinical doses causes immediate and transient renal calcium and magnesium wasting normal!
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