title: [Factors contributing to increases in serum creatinine following treatment with a sulfamethoxazole-trimethoprim combination product: retrospective analysis of Japanese patients with normal renal function].
abstract: Japanese patients with normal renal function were retrospectively analyzed to characterize increases in serum creatinine (SCr) observed following the use of a sulfamethoxazole-trimethoprim (SMX-TMP) combination product and identify factors affecting these increases. In the patients studied (n=49), an individual comparison was conducted for the three factors of age group [≤74 years (n=21) vs. ≥75 years (n=28)], sex [male (n=24) vs. female (n=25)], and total dose throughout the treatment period [≤7 g (n=24) vs. ≥8 g (n=25)] to determine the extent of SCr increase following SMX-TMP combination product use. SCr increased significantly following SMX-TMP combination product use in patients ≤74 years of age and ≥75 years of age, in both males and females, and in patients with a total dose of ≥8 g (8 to 96 g) (p<0.05). Multivariate logistic regression analysis was used to determine the independence of these factors. Total dose was identified as an independent factor and had an odds ratio of 6.571 [95% confidence interval=1.735-24.882, p=0.006]. Post-treatment percent increases in SCr were compared using pre-treatment levels as the baseline. The group with a total dose of ≥8 g (mean 29.8 g) had a significant SCr increase of 18.4% (p=0.002), while the increase in the ≤7 g (mean 5.3 g) group was only 4.5%. The data showed that SCr increased by about 20% when the total dose taken over the treatment period was around 30 g (about 2.4 g as TMP) and indicated that total dose contributes more than age and sex to the post-treatment increase in SCr.
authors: Department of Pharmacy, Juntendo Tokyo Koto Geriatric Medical Center.
authors: Muramori
authors: M
authors: So
authors: Toyofumi
authors: T
authors: Suzuki
authors: Kenji
authors: K
authors: Takano
authors: Kohei
authors: K
authors: Shimada
authors: Mayumi
authors: M
authors: Inoue
authors: Tatsumi
authors: T
authors: Kawai
authors: Toshiro
authors: T
authors: Fukami
authors: Kazuo
authors: K
authors: Tomono
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects; D044466:Asian People; D003404:Creatinine / Q000097:blood*; D004232:Diuretics / Q000008:administration & dosage / Q000009:adverse effects; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004232:Diuretics; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003404:Creatinine