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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

Insights

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.
  • 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.

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