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Use of aminoglycosides for peritoneal dialysis-associated peritonitis does not affect residual renal function

Sunil V Badve1, Carmel M Hawley, Stephen P McDonald

  • 1Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|June 3, 2011
PubMed
Abstract

Insights

Aminoglycoside use for peritoneal dialysis peritonitis did not accelerate the loss of residual renal function in patients. This study found no adverse effects on kidney function from these common antibiotics.

Area of Science:

  • Nephrology
  • Pharmacology
  • Infectious Diseases

Background:

  • Aminoglycosides are beneficial for peritonitis treatment due to cost, efficacy, and low resistance promotion.
  • Conflicting evidence exists regarding aminoglycosides potentially accelerating residual renal function (RRF) loss in peritoneal dialysis (PD) patients.

Purpose of the Study:

  • To investigate the impact of aminoglycoside use on the rate of RRF decline in PD patients.

Main Methods:

  • A cohort of 2715 Australian PD patients (2003-2007) with serial renal creatinine clearance measurements were analyzed.
  • Patients were categorized by RRF decline slope (rapid, intermediate, slow).
  • The primary outcome compared RRF slope between patients receiving aminoglycosides for peritonitis and those who did not.

Main Results:

  • Of 1412 patients with peritonitis, 1075 received initial empiric aminoglycoside therapy.
  • No significant difference in RRF decline slope was observed between patients treated with aminoglycosides and those not treated (median -0.26 vs. -0.22 mL/min/1.73 m²/month, P=0.9).
  • Repeated aminoglycoside courses also showed similar RRF decline slopes.

Conclusions:

  • Empiric aminoglycoside treatment for peritonitis is not associated with accelerated RRF loss in PD patients.
  • Findings suggest aminoglycosides can be safely used without negatively impacting kidney function in this population.

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