TMP-SMX Effect(s) on Renal Function and Population Factors that may increase the risk of AKI

Abstract

Specific Aims: To explore what patient specific factors may predispose an individual to experiencing a true Acute Kidney Injury (AKI) with Sulfamethoxazole Trimethoprim (TMP/SMX) in the first 10 days of treatment. The findings then can be used by providers to better differentiate a true AKI from pseudo renal failure when they notice an increase in serum creatinine (sCr) due to TMP/SMX. Subjects: Patients will be included in the study if they are: adults (18 years of age or older), who at the time of TMP/SMX initiation had stable renal function and received a TMP/SMX dose of ≥ 160mg/800mg for at least 72 hours. Methods: Using the facility’s electronic health record system (Cerner) we generated a report of patients who received a minimum daily dose of TMP ≥320 mg and were discharged between March 01 2020 and August 31 2020. Main Results: Of the 102 patients screened from Banner University Medical Center Tucson that we screened 23 patients met our inclusion criteria. AKI was found in 8 of the 23 subjects and was more common with increased comorbidities, nephrotoxic drugs, and contrast agents, supporting current literature. Conclusions: In our 8 subjects with AKI, we found that occurrence of AKI occurred in the setting of multiple comorbidities and/or with nephrotoxic agents.