Empirical aminoglycosides for peritonitis do not affect residual renal function.

Area of Science:

• Nephrology
• Internal Medicine
• Infectious Diseases

Background:

• Aminoglycosides are effective for peritonitis but raise concerns regarding nephrotoxicity and residual renal function (RRF).
• Previous guidelines recommended against aminoglycoside use in patients with RRF.
• This study investigates the impact of aminoglycoside-based peritonitis treatment on RRF.

Purpose of the Study:

• To compare changes in renal function after peritonitis treatment with and without aminoglycosides.
• To evaluate the safety of aminoglycoside-containing regimens in preserving residual renal function.

Main Methods:

• Retrospective analysis of 70 peritonitis episodes treated with aminoglycosides (Group A), 61 without (Group B), and 74 controls (Group C).
• Measured pre- and post-peritonitis residual renal function (RRF) using 6-monthly urine and dialysis clearance measurements (urea and creatinine).

Main Results:

• No significant differences in the decline of estimated glomerular filtration rate (eGFR) or urine output were observed between Group A (aminoglycoside-based) and Group B (non-aminoglycoside).
• Declines in eGFR and urine output in both treatment groups were comparable to the control group without peritonitis.
• The mean decline in eGFR was -0.08 mL/min/mon for Group A vs. -0.17 mL/min/mon for Group B.
• The mean decline in urine output was -8.82 mL/24 h/mon for Group A vs. -34.68 mL/24 h/mon for Group B.

Conclusions:

• Empirical peritonitis treatment regimens containing aminoglycosides did not accelerate the decline of residual renal function in this patient cohort.
• The findings support the continued use of aminoglycosides in peritonitis treatment, even for patients with significant RRF.
• Further research may be warranted, but current data suggest aminoglycosides are a safe option for peritonitis management.