The clinical utility of a published nomogram to predict aminoglycoside nephrotoxicity

Moore and colleagues recently published a nomogram for predicting the risk of aminoglycoside nephrotoxicity. This study was undertaken to evaluate the clinical usefulness of this nomogram. The nephrotoxicity risk scores of 61 patients were determined using parameters suggested by Moore et al. Thirteen patients (21%) could not be scored because their initial creatinine clearances exceeded the upper limit of the nomogram. Six patients (9.8%) developed nephrotoxicity (defined as a greater than or equal to 50% decrease in creatinine clearance). In five of these patients in whom risk scores could be determined, the scores were estimated at 14% or less. Twenty patients had risk scores of 10% or more (four patients, greater than or equal to 50%) without developing nephrotoxicity. These results demonstrate that this nomogram may have limited clinical application in predicting patients likely to develop aminoglycoside nephrotoxicity.