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Aminoglycosides and renal acid excretion
Summary
Aminoglycoside antibiotics like gentamicin and amikacin can impair kidney function, specifically decreasing glomerular filtration rate (GFR) and renal plasma flow (RPF). During metabolic acidosis, all tested aminoglycosides significantly reduced net acid excretion, warranting further clinical investigation.
Area of Science:
- Nephrology
- Pharmacology
- Toxicology
Background:
- Aminoglycosides are potent antibiotics used to treat severe bacterial infections.
- Nephrotoxicity is a known side effect of aminoglycoside therapy.
- The impact of aminoglycosides on renal acid-base balance, particularly during acidosis, requires further elucidation.
Purpose of the Study:
- To investigate the effects of gentamicin, netilmicin, and amikacin on renal acid excretion in rats.
- To assess how these aminoglycosides alter kidney function markers under normal and acidotic conditions.
Main Methods:
- Rats were administered aminoglycosides at doses 10 times the clinical equivalent.
- Glomerular filtration rate (GFR), renal plasma flow (RPF), and U/P inulin ratio were measured.
- Net acid excretion (BH) was calculated by measuring ammonium (NH4+), titratable acidity (AT), and bicarbonate (CHCO3-) excretion.
Main Results:
- Gentamicin and amikacin significantly decreased GFR, U/P inulin ratio, and RPF in normal rats.
- Under acidotic conditions, gentamicin altered GFR and RPF, while all tested aminoglycosides reduced net acid excretion (BH) by decreasing NH4+ and AT.
- Netilmicin significantly lowered NH4+ and AT, decreasing BH in normal conditions, but showed no effect on these parameters with other drugs.
Conclusions:
- Aminoglycosides, particularly gentamicin and amikacin, can impair renal function.
- All tested aminoglycosides negatively impact renal acid excretion during acute metabolic acidosis.
- Clinical implications of aminoglycoside use during metabolic acidosis warrant further investigation due to potential adverse effects.