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Aminoglycoside and nephrotoxicity.

V L Silva1, F Z Gil, G Nascimento

  • 1Departamento de Fisiologia, Escola Paulista de Medicina, São Paulo, Brasil.

Renal Physiology
|January 1, 1988
PubMed
Summary
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Aminoglycoside antibiotics like gentamicin can impair kidney function, especially during metabolic acidosis. Gentamicin showed more nephrotoxicity than amikacin or netilmicin in rats, potentially worsening acid retention.

Area of Science:

  • Nephrology
  • Pharmacology
  • Toxicology

Background:

  • Aminoglycosides are widely used antibiotics.
  • Nephrotoxicity is a known side effect of aminoglycosides.
  • The impact of aminoglycosides on renal acid excretion is not fully understood.

Purpose of the Study:

  • To investigate the effects of gentamicin, netilmicin, and amikacin on renal acid excretion in male rats.
  • To compare the nephrotoxic potential of these aminoglycosides.
  • To assess the implications for clinical use during metabolic acidosis.

Main Methods:

  • Male rats were administered doses of gentamicin, netilmicin, and amikacin equivalent to clinical doses.
  • Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and U/P inulin ratio were measured under normal and acidotic conditions.

Related Experiment Videos

  • Net acid excretion (BH) and urine-blood pCO2 were assessed.

    • Main Results:

    • Gentamicin administration led to decreased GFR, ERPF, and U/P inulin ratio, indicating higher nephrotoxicity compared to amikacin and netilmicin.
    • Net acid excretion (BH) decreased significantly after an acute acid load, irrespective of the aminoglycoside used.
    • The distal tubule function, assessed by urine-blood pCO2 elevation after alkaline overload, remained largely unaffected.

    Conclusions:

    • Gentamicin exhibits greater nephrotoxicity than amikacin and netilmicin in rats.
    • Aminoglycoside use during metabolic acidosis warrants caution due to potential acid retention.
    • Further research is needed to understand the clinical implications of these findings.