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[Renal tolerance for aminoglycosides]

R Ragni, G Sancipriano, T Fidelio

    Minerva Medica
    |February 25, 1982
    PubMed
    Summary
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    Aminoglycoside antibiotics can cause kidney damage (tubulopathy) by concentrating in the renal cortex. Monitoring dosage, duration, and patient factors is crucial to prevent and manage this nephrotoxicity.

    Area of Science:

    • Pharmacology
    • Nephrology
    • Toxicology

    Context:

    • Aminoglycosides are widely used antibiotics.
    • Their pharmacokinetic profile leads to accumulation in renal tubules.
    • Understanding their nephrotoxic potential is critical for patient safety.

    Purpose:

    • To describe the pharmacokinetics, renal lesion morphology, and clinical presentation of aminoglycoside-induced tubulopathy.
    • To identify and discuss risk factors associated with aminoglycoside nephrotoxicity.
    • To provide recommendations for safe aminoglycoside therapy.

    Summary:

    • Aminoglycosides are filtered by glomeruli and reabsorbed by proximal tubules, reaching peak renal cortex concentration within six hours.
    • High doses can cause cellular lesions, leading to polyuria, proteinuria, enzymuria, and potentially renal insufficiency.

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  • Risk factors include treatment duration, dosage, age, and co-administration with other nephrotoxic drugs.

    • Impact:

    • Highlights the importance of dose-time factor in aminoglycoside-induced renal function deterioration.
    • Emphasizes the need for pre-treatment assessment of renal function and patient history.
    • Recommends vigilant monitoring of renal function (creatinine, urea) during therapy to mitigate nephrotoxicity.