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Aminoglycoside-induced nephrotoxicity in children
Stephen J McWilliam1, Daniel J Antoine2, Rosalind L Smyth3
1Department of Women's and Children's Health, University of Liverpool, Liverpool, UK. stevemcw@liv.ac.uk.
Pediatric Nephrology (Berlin, Germany)
|November 17, 2016
Summary
Aminoglycoside antibiotics like gentamicin can cause acute kidney injury (AKI) in children. Strategies like extended dosing and statin use may prevent this common nephrotoxicity.
Area of Science:
- Nephrology
- Pharmacology
- Pediatrics
Background:
- Aminoglycoside antibiotics (gentamicin, tobramycin) are widely used in children.
- These drugs cause nephrotoxicity, damaging proximal tubule cells via megalin-mediated endocytosis.
- Acute kidney injury (AKI) affects 20-33% of pediatric patients exposed to aminoglycosides.
Purpose of the Study:
- To review current understanding and management of aminoglycoside-induced nephrotoxicity in children.
- To highlight novel biomarkers and preventative strategies for clinical application.
Main Methods:
- Review of recent epidemiological studies and consensus criteria for aminoglycoside nephrotoxicity.
- Evaluation of novel renal biomarkers (e.g., kidney injury molecule-1).
- Assessment of preventative strategies including extended interval dosing and statin inhibition of endocytosis.
Main Results:
- Consensus phenotypic criteria for aminoglycoside-induced nephrotoxicity have been established.
- Novel biomarkers like kidney injury molecule-1 detect proximal tubular injury earlier than traditional markers.
- Extended interval dosing reduces nephrotoxicity, and statins show promise in preventing it.
Conclusions:
- Aminoglycoside nephrotoxicity is a significant concern in pediatric patients.
- Novel biomarkers and preventative strategies offer potential for improved patient outcomes.
- Further research is needed to translate these findings into widespread clinical practice.
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