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Renal function and effect of aminoglycoside therapy during the first ten days of life

Vasilios I Giapros1, Styliani K Andronikou, Vasilios I Cholevas

  • 1Neonatology Clinic, Child Health Department, University of Ioannina Medical School, PO Box 1186, Ioannina 451 10, Greece.

Pediatric Nephrology (Berlin, Germany)
|December 19, 2002
PubMed

Insights

Aminoglycoside antibiotics can impact kidney function in newborns. Preterm infants show more significant kidney tubular disturbances than full-term infants, depending on the specific drug used.

Area of Science:

  • Neonatal Nephrology
  • Pharmacology
  • Pediatric Infectious Diseases

Background:

  • Aminoglycosides are commonly used antibiotics in neonates to treat infections.
  • Kidney function and maturation are critical in newborns, especially preterm infants.
  • The impact of aminoglycosides on immature renal tubules requires further investigation.

Purpose of the Study:

  • To evaluate the effect of aminoglycoside administration on kidney functional maturation in preterm and full-term infants.
  • To compare the renal tubular function changes induced by different aminoglycosides.
  • To assess the influence of gestational age on aminoglycoside-induced nephrotoxicity.

Main Methods:

  • Groups of preterm (32.5–33.6 weeks) and full-term infants received one of three aminoglycosides for 7 days.
  • Renal tubular function was assessed by measuring fractional excretion of sodium (FENa), potassium (FEK), phosphorus (FEP), magnesium (FEMg), uric acid (FEUA), and the calcium/creatinine (UCa/UCr) ratio.
  • Control groups of preterm and full-term infants not receiving antibiotics were used for comparison.

Main Results:

  • Aminoglycosides affected the normal decline in plasma creatinine (PCr) in both preterm and full-term infants.
  • Disturbances in FENa and UCa/UCr were more pronounced in treated preterm infants compared to full-term infants, particularly with netilmicin and gentamicin.
  • FEMg was significantly affected in preterm infants treated with gentamicin.

Conclusions:

  • The nephrotoxic effects of aminoglycosides on renal tubular function are dependent on kidney maturity.
  • The specific type of aminoglycoside administered influences the degree of renal tubular dysfunction.
  • Preterm infants are more susceptible to aminoglycoside-induced renal tubular disturbances than full-term infants.

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