Development of glomerular filtration rate and excretion of beta 2-microglobulin in neonates during gentamicin...

Ten infants of different gestational ages (GA) and postnatal ages (PNA), treated with gentamicin, were compared with 10 control patients of similar GA and PNA to evaluate the possible nephrotoxic effects of this drug. Changes in the glomerular filtration rate (GFR) and the fractional excretion of beta 2-microglobulin in urine (FE beta) were used as indicators of renal dysfunction. In the control infants there was a postnatal increase in the GFR that was higher in full-term than in preterm infants. The FE beta decreased logarithmically as a function of both the GA and the PNA. The GFR was statistically lower in 5/10 and 6/10 of the patients on the first and the last days of gentamicin treatment (GT) respectively. Three weeks after GT, 8/10 had a normal GFR. The FE beta was statistically higher in 4/10 of the patients on their first day of GT and 7/10 on their last day of GT. Three weeks after GT, 9/10 of the patients had a normal FE beta for their postnatal and gestational ages. It is concluded that GT influences filtration and proximal reabsorption in GT infants by decreasing the GFR and increasing the FE beta. However, the observed renal dysfunction seemed to be reversible.