[Sulfadiazine nephrolithiasis and nephropathy].
Sulfadiazine-nephropathy and -nephrolithiasis were well known complications of high dose sulfadiazine therapy 50 years ago. In the last few years high dose sulfadiazine therapy has been widely used for treatment of toxoplasmic encephalitis in AIDS patients. As a consequence sulfadiazine-nephropathy and -nephrolithiasis have become increasingly common. We describe 2 patients with the typical picture of these complications. Therapy is based on the fact that the solubility of sulfadiazine and its acetylated metabolite are markedly improved at higher urine-pH levels. Urine alkalinization is also effective for prophylaxis during sulfadiazine treatment. We present our guidelines for prophylaxis and treatment of these complications.
Medizinische Universitätspoliklinik, Inselspital Bern.
H
H
Furrer
J
J
von Overbeck
P
P
Jaeger
B
B
Hess
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D001639:Bicarbonates / Q000627:therapeutic use; D005440:Fluid Therapy; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D006869:Hydronephrosis / Q000139:chemically induced; D007669:Kidney Calculi / Q000139:chemically induced* / Q000737:chemistry; D008297:Male; D013411:Sulfadiazine / Q000009:adverse effects* / Q000032:analysis / Q000627:therapeutic use; D016781:Toxoplasmosis, Cerebral / Q000150:complications / Q000188:drug therapy*; D014514:Ureteral Calculi / Q000139:chemically induced / Q000737:chemistry
D001639:Bicarbonates; D013411:Sulfadiazine
Sulfadiazin-Nephrolithiasis und-Nephropathie.