Summary
Clinical observations have shown, that administration of Co-trimoxazole (Trimethoprim-Sulfamethoxazole) may result in an elevation of the serum-creatinine level.
In 27 subjects the endogenous creatinine- and inulinclearance were measured before and during oral or parenteral application of Co-trimoxazole. The inulinclearance showed no significant differences (p>0,05). But the endogenous creatinine clearance showed a reduction of 18% during the oral and of 13% during the parenteral treatment (p≦0,05)
These observations indicate a functional inhibition of the tubular creatinine secretion by Co-trimoxazole.
Zusammenfassung
Klinische Beobachtungen haben gezeigt, daß Co-Trimoxazol (Trimethoprim — Sulfamethoxazol) zu einem Anstieg des Serum-Kreatinins führen kann.
Daher wurden bei 27 nierengesunden Probanden vor und während oraler und parenteraler Co-Trimoxazolgabe Clearanceuntersuchungen (endogene Kreatinin-und Inulinclearance) durchgeführt. Während die Inulinclearance keine signifikanten Änderungen aufwies, war die endogene Kreatininclearance nach oraler Zufuhr von Co-Trimoxazol um 18% und während parenteraler Gabe des Medikamentes um 13% herabgesetzt (p≦0,05).
Diese Befunde sprechen für eine funktionelle Hemmung der tubulären Kreatininsekretion durch Co-Trimoxazol.
This is a preview of subscription content, log in via an institution to check access.
Literatur
Berglund, F., Killander, J., Pompeius, R.: Effect of trimethoprim-sulfamethoxazole on the renal excretion of creatinine in man. J. Urol.114, 802–808 (1975)
Bräutigam, M.: Dissertationsarbeit. Freie Universität Berlin 1977
Crawford, B.: Depression of the exogenous creatinine/inulin or thiosulfate clearance ratios in man by diodrost and p-aminohippuric acid. J. clin. Invest.27, 171–175 (1948)
Documenta Geigy: Wissenschaftliche Tabellen 7. Ausgabe. Stuttgart: Georg Thieme Verlag, 1975
Horn, B., Cottier, P.: Kreatininkonzentration im Serum vor und unter Behandlung mit Trimethoprim-Sulfamethoxazol (Bactrim). Schweiz. med. Wschr.104, 1809–1812 (1974)
Kalowski, S., Nanra, R.S., Mathew, Th., Kincaid-Smith, P.: Deterioration in renal function in association with cotrimoxazole therapy. Lancet,I, 394–397 (1973)
Knoll, E., Stamm, D.: Spezifische Kreatininbestimmung im Serum. Z. klin. Chem.,8, 582–587 (1970)
Pitts, R.F.: Physiology of the kidney and body fluids. Second edition. Chicago, Year Book Medical Publishers Inc., 1972
Richterich, R.: Klinische Chemie, Theorie und Praxis. 3. Auflage Basel: S. Krager AG, 1971
Rieder, J.: Quantitative determination of the bacteriostatically active fraction of the sulfonamides and the sum of their inactive metabolites in the body fluids. Chemotherapy,17, 1–21 (1972)
Rosenfeld, J.B., Najenson, T., Grosswater, Z.: Effect of long-term co-trimoxazole therapy on renal function. Med. J. Aust.2, 546–548 (1975)
Selkurt, E.E., Wathen, R.L., Santos-Martinez, J.: Creatinine excretion in the squirrel monkey. Fed. Proc.26, 266 (1967)
Shannon, J.A.: The renal excretion of creatinine in man. J. clin. Invest.14, 403–410 (1935)
Shouval, D., Ligumsky, M., Ben-Ishay, D.: Effect of cotrimoazole on normal creatinine clearance. LancetI, 244–245 (1978)
Smith, H.W.: The Kidney, Structur and Function in health and disease. Fourth printing. New York, Oxford University Press, 1964
Tasker, P.R., MacGregor, G.A., de Wardener, H.E.: Use of co-trimoxazole in chronic renal failure. LancetI, 1216–1218 (1975)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bräutigam, M., Froese, P., Baethke, R. et al. Zur Kreatininausscheidung beim Menschen nach Gabe von Co-Trimoxazol. Klin Wochenschr 57, 95–96 (1979). https://doi.org/10.1007/BF01491342
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01491342