SULFADIAZINE-NEPHROPATHY AND SULFADIAZINE -NEPHROLITHIASIS

Sulfadiazine-nephropathy and -nephrolithiasis were well known complica tions of high dose sulfadiazine therapy 50 years ago. In the last few years high dose sulfadiazine therapy has been widely used for treatmen t of toxoplasmic encephalitis in AIDS patients. As a consequence sulfa diazine-nephropathy and -nephrolithiasis have become increasingly comm on. We describe 2 patients with the typical picture of these complicat ions. Therapy is based on the fact that the solubility of sulfadiazine and its acetylated metabolite are markedly improved at higher urine-p H levels. Urine alkalinization is also effective for prophylaxis durin g sulfadiazine treatment. We present our guidelines for prophylaxis an d treatment of these complications.