Aminoglycoside Nephrotoxicity — Clinical and Experimental Observations

  • Raymond D. Adelman
Part of the Developments in Nephrology book series (DINE, volume 11)


The aminoglycoside antibiotics are widely used in the pediatric age population for the treatment of serious gram negative infections. The incidence of nephrotoxicity in patients receiving aminoglycosides varies according to the criteria defining nephrotoxicity, the aminoglycoside used, and the presence or absence of risk factors. One proposed risk factor is sodium depletion. Although clinical information is largely anecdotal, substantial experimental data support the influence of sodium balance on aminoglycoside nephrotoxicity.


Glomerular Filtration Rate Acute Renal Failure Plasma Creatinine Renin Angiotensin System Uranyl Nitrate 
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  1. 1.
    McDonald FD, Thiel G, Wilson DR, et al: The prevention of acute renal failure in the rat by long-term saline loading: A possible role of the renin-angiotensin axis. Proc. Soc. Exp. Biol. Med. 131: 610, 1969.PubMedGoogle Scholar
  2. 2.
    Bidani A, Churchill P, and Fleischmann L: Sodium chloride induced protection in nephrotoxic acute renal failure: Independence from renin. Kid. Intl. 16: 481, 1979.CrossRefGoogle Scholar
  3. 3.
    Ryan R, McNeil JS, Flamenbaum W, Nogle R: Uranyl nitrate induced acute renal failure in the rat: Effect of varying doses and saline loading. Proc. Soc. Exp. Biol. Med. 143: 289, 1973.PubMedGoogle Scholar
  4. 4.
    Schor N, Ichikawa I, Rennke HG, et al: Pathophysiology of altered glomerular function in aminoglycoside treated rats. Kid. Intl. 19: 288, 1981.CrossRefGoogle Scholar
  5. 5.
    Dibona GF and Sawin LE: The renin angiotensin system in acute renal failure in the rat. Lab Invest. 25: 528, 1971.PubMedGoogle Scholar
  6. 6.
    Bennett WM, Hartnett MN, Gilbert D, et al: Effect of sodium intake on gentamicin nephrotoxicity in the rat. Proc. Soc. Exp. Biol. Med. 151: 736, 1976.PubMedGoogle Scholar
  7. 7.
    Adelman RD and Wright J: “Natural” Na loading, a critical variable in experimental nephrotoxicity studies in the rat. Clinical Research 30: 153A, 1982.Google Scholar
  8. 8.
    Lawson DH, Macadam RF, Singh H, et al: Effect of furosemide on antibiotic induced renal damage in rats. J. Infect. Dis. 126: 593, 1972.PubMedCrossRefGoogle Scholar
  9. 9.
    Adelman RD, Spangler WL, Beasom F, et al: Furosemide enhancement of experimental gentamicin nephrotoxicity: Comparison of functional and morphological changes with activities of urinary enzymes. J. Infect. Dis. 140: 3, 1979.CrossRefGoogle Scholar
  10. 10.
    Adelman RD, Spangler WL, Beasom F, and Ishizaki G: Furosemide enhancement of netilmicin nephrotoxicity in dogs. J. Antimicrob. Chemoth. 7: 431, 1981.CrossRefGoogle Scholar
  11. 11.
    Adelman RD, Spangler W, Thomson D, Beasom F: The role of volume depletion in furosemide enhanced aminoglycoside nephrotoxicity. Kid. Intl. 16: 771 (A), 1979.Google Scholar
  12. 12.
    Milman N: Renal failure associated with gentamicin therapy. Acta. Med. Scand. 196: 87, 1974.PubMedCrossRefGoogle Scholar
  13. 13.
    Smith CR, Lipsky JJ, Laskin OL, et al: Double blind comparison of the nephrotoxicity and auditory toxicity of gentamicin and tobramycin. NEJM 302: 1106, 1980.PubMedCrossRefGoogle Scholar
  14. 14.
    Anderson RJ and Schrier RW: Clinical spectrum of oliguric and nonoliguric renal failure in Acute Renal Failure, (Eds) Brenner BM and Stein JH. Churchill Livingston, New York, 1980.Google Scholar
  15. 15.
    Keys TF, Kurtz SB, Jones JD, et al: Renal toxicity during therapy with gentamicin or tobramycin. Mayo Clin. Proc. 56: 556–559, 1981.Google Scholar
  16. 16.
    Trollfors B, Alestig K, Krantz I, et al: Quantative nephrotoxicity of gentamicin in nontoxic doses. J. of Infect. Dis. 141: 3, 1980.Google Scholar
  17. 17.
    Pelayo JC, Andrews PM, Coffee AK, et al: The influence of age on acute renal toxicity of uranyl nitrate in the dog. Ped. Research 17: 12, 1983.Google Scholar
  18. 18.
    Bidani A and Churchill P: Effects of sodium intake and nephrotoxin dose on acute renal failure in the young rat. Ped. Research 16: 277, 1982.Google Scholar
  19. 19.
    McCrory WW: In Developmental Nephrology, Harvard University Press, Cambridge, 1972, p 94.Google Scholar
  20. 20.
    Chonko A, Savin V, Stewart R, et al: The effects of gentamicin on renal function in the mature versus immature rabbit. Proc. Am. Soc. Nephrol. 12: 2A, 1979.Google Scholar
  21. 21.
    Cowan RH, Jukkola AF, Arant, Jr BS: Pathophysiologic evidence of gentamicin nephrotoxicity in neonatal puppies. Pediatr. Res. 14: 1204–1211, 1980.PubMedCrossRefGoogle Scholar
  22. 22.
    Milner RDG: Gentamicin in the newborn. Post Grad. Med. Journal 50:Sup. 7, 40–4, 1974.Google Scholar
  23. 23.
    McCracken GH, Jr. and Jones, LG: Gentamicin in the neonatal period. Am. J. Dis. Child. 120: 524, 1970.PubMedGoogle Scholar
  24. 24.
    Tessin I, Bergmark J, Hiesche K, et al: Renal function of neonates during gentamicin treatment. Arch. Dis. in Child. 57:10, 758–760, 1982.Google Scholar
  25. 25.
    Adelman RD and Zakauddin S: Urinary enzyme activities in children and neonates receiving gentamicin therapy. Dev. Pharmacol. Ther. 1: 325–332, 1980.Google Scholar
  26. 26.
    Elinder G and Aperia A: Development of glomerular filtration rate and excretion of β2-microglobulin in neonates during gentamicin treatment. Acta Paediatr. Scand. 72: 219–224, 1983.Google Scholar
  27. 27.
    Feldman H and Guignard JP: Plasma creatinine in the first month of life. Archives of Disease in Childhood 57: 123–126, 1982.PubMedCrossRefGoogle Scholar
  28. 28.
    Rajchgot P, Prober C, Klein J, et al: Aminoglycoside nephrotoxicity in premature neonates: Amikacin and gentamicin compared. Ped. Research 17: 4, 154A, 1983.Google Scholar
  29. 29.
    Russo JC and Adelman RD: Gentamicin-induced Fanconi syndrome. J. of Ped. 96: 151–153, 1980.CrossRefGoogle Scholar

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© Martinus Nijhoff Publishing, Boston 1986

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  • Raymond D. Adelman

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