Impact of Very Low-Dose Trimethoprim-Sulfamethoxazole on Serum Creatinine after Renal Transplantation: A Retrospective Study

Yamanaga, Shigeyoshi; Tanaka, Kosuke; Kinoshita, Kohei; Kaba, Akari; Fujii, Mika; Ogata, Masatomo; Hidaka, Yoshiki; Kawabata, Chiaki; Toyoda, Mariko; Uekihara, Soichi; Kashima, Masayuki; Miyata, Akira; Inadome, Akito; Yasuda, Hiroshi

doi:10.1016/j.transproceed.2020.01.148

Cited by 2 publications

(1 citation statement)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, the use of low-dose trimethoprim-sulfamethoxazole did not appear to impact the Cr concentrations and thus, the GFR estimates. In contrast, in a retrospective study of 76 adult kidney transplant recipients, Yamanaga et al concluded very low-dose trimethoprim-sulfamethoxazole for Pneumocystis jirovecii pneumonia prophylaxis reversibly increased Cr by 6% [ 38 ]. The cumulative impact of factors that determine Cr levels can certainly affect the utility of Cr in accurately assessing GFR in the pediatric kidney transplant population and thus supports the use of both Cr and CysC post-transplantation.…”

Section: Discussionmentioning

confidence: 99%

Comparison of estimated GFR using cystatin C versus creatinine in pediatric kidney transplant recipients

Pizzo,

Nguyen,

Schwartz

et al. 2024

Pediatr Nephrol

View full text Add to dashboard Cite

Background An accurate, rapid estimate of glomerular filtration rate (GFR) in kidney transplant patients affords early detection of transplant deterioration and timely intervention. This study compared the performance of serum creatinine (Cr) and cystatin C (CysC)-based GFR equations to measured GFR (mGFR) using iohexol among pediatric kidney transplant recipients. Methods CysC, Cr, and mGFR were obtained from 45 kidney transplant patients, 1–18 years old. Cr- and CysC-estimated GFR (eGFR) was compared against mGFR using the Cr-based (Bedside Schwartz, U25-Cr), CysC-based (Gentian CysC, CAPA, U25-CysC), and Cr-CysC combination (CKiD Cr-CysC, U25 Cr-CysC) equations in terms of bias, precision, and accuracy. Bland–Altman plots assessed the agreement between eGFR and mGFR. Secondary analyses evaluated the formulas in patients with biopsy-proven histological changes, and K/DOQI CKD staging. Results Bias was small with Gentian CysC (0.1 ml/min/1.73 m2); 88.9% and 37.8% of U25-CysC estimations were within 30% and 10% of mGFR, respectively. In subjects with histological changes on biopsy, Gentian CysC had a small bias and U25-CysC were more accurate—both with 83.3% of and 41.7% of estimates within 30% and 10% mGFR, respectively. Precision was better with U25-CysC, CKiD Cr-CysC, and U25 Cr-CysC. Bland–Altman plots showed the Bedside Schwartz, Gentian CysC, CAPA, and U25-CysC tend to overestimate GFR when > 100 ml/min/1.72 m2. CAPA misclassified CKD stage the least (whole cohort 24.4%, histological changes on biopsy 33.3%). Conclusions In this small cohort, CysC-based equations with or without Cr may have better bias, precision, and accuracy in predicting GFR. Graphical abstract

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of estimated GFR using cystatin C versus creatinine in pediatric kidney transplant recipients

Pizzo,

Nguyen,

Schwartz

et al. 2024

Pediatr Nephrol

View full text Add to dashboard Cite

show abstract

Hyperkalemic effect of drug–drug interaction between esaxerenone and trimethoprim in patients with hypertension: a pilot study

Hirai,

Ueda,

Ogura

et al. 2024

J Pharm Health Care Sci

View full text Add to dashboard Cite

Background We examined whether the pharmacodynamic drug–drug interaction between esaxerenone and trimethoprim enhances the hyperkalemic effect. Methods A retrospective observational study was conducted to identify patients >18 years undertaking esaxerenone alone or esaxerenone plus trimethoprim at Mie University Hospital from May 2019 to December 2022. We performed propensity score-matching (1:1) to compare between-group differences in the maximum change in serum potassium levels (ΔK) using the Mann–Whitney U test. For esaxerenone plus trimethoprim, Spearman's correlation coefficients were used to examine correlations between ΔK and variables, including changes in blood urea nitrogen (ΔBUN), serum creatinine levels (ΔCr), and weekly trimethoprim cumulative dose. Results Out of propensity score-matched groups (n=8 each), serum potassium levels significantly increased after administration of esaxerenone alone (4.4 [4.2 to 4.7] meq/L to 5.2 [4.7 to 5.4] meq/L, p=0.008) and esaxerenone plus trimethoprim (4.2 [4.0 to 5.1] meq/L to 5.4 [4.7 to 5.5] meq/L, p=0.023). ΔK did not significantly differ between the groups (esaxerenone alone; 0.6 [0.3 to 0.9] meq/L vs. esaxerenone plus trimethoprim; 1.0 [0.4 to 1.3] meq/L, p=0.342). ΔK positively correlated with ΔBUN (r=0.988, p<0.001) or ΔCr (r=0.800, p=0.017). There was a trend of correlation of ΔK with a weekly cumulative trimethoprim dose (r=0.607, p=0.110). Conclusions The hyperkalemic effect of the drug–drug interaction between esaxerenone and trimethoprim is not notable and related to renal function and trimethoprim dosage.

show abstract

Impact of Very Low-Dose Trimethoprim-Sulfamethoxazole on Serum Creatinine after Renal Transplantation: A Retrospective Study

Cited by 2 publications

References 22 publications

Comparison of estimated GFR using cystatin C versus creatinine in pediatric kidney transplant recipients

Comparison of estimated GFR using cystatin C versus creatinine in pediatric kidney transplant recipients

Hyperkalemic effect of drug–drug interaction between esaxerenone and trimethoprim in patients with hypertension: a pilot study

Contact Info

Product

Resources

About