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Aminoglycoside nephrotoxicity following single-dose cystoscopy prophylaxis
1Department of Pharmacy, Sinai Samaritan Medical Center, Milwaukee, WI 53233.
Objective:
To report a case of gentamicin-associated acute tubular necrosis following single-dose exposure.
Setting:
Central-city, university-affiliated teaching hospital.
Patient:
An 82-year-old man, admitted for evaluation of shortness of breath, appetite reduction with weight loss, and stable renal insufficiency, developed urinary retention, which prompted a urologic evaluation followed by a cystoscopy.
Interventions:
A single 1.6-mg/kg (actual body weight) dose of gentamicin was administered as prophylaxis prior to this procedure.
Results:
A significant decline in renal function was observed 48 hours following gentamicin administration. A nephrology evaluation excluded pre- and postrenal causes and attributed this episode of nonoliguric acute tubular necrosis to a single dose of gentamicin.
Conclusions:
Although not consistent with currently proposed mechanisms and reported onset of aminoglycoside-induced nephrotoxicity, an etiology other than that concluded by this case report appears unlikely.