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Gentamicin-Associated Acute Renal Failure

Gentamicin-Associated Acute Renal Failure Abstract Five patients are described in whom only gentamicin sulfate appeared responsible for acute renal failure. Subjects received 1.2 to 2.88 gm over 12 to 18 days. All were over 45 years of age, and premorbid kidney abnormalities may have enhanced susceptibility to toxic effects of the drug. Renal failure appeared 8 to 17 days after beginning gentamicin therapy and was characterized by creatinine clearances 4 to 10 ml/min, urine to plasma creatinine ratios < 20, urinary sodium concentrations 16 to 60 mEq/ liter, proteinuria, and cylindruria. Oliguria was not observed and this feature may impair recognition of kidney damage. Clinical recovery required an average of 42 days and was complete in four of five patients. Gentamicin alone may be nephrotoxic and should be given with particular caution to the elderly and those with even mild kidney abnormalities. (Arch Intern Med 136:1101-1104, 1976) References 1. Burton JR, Lichenstein NS, Colvin RB, et al: Acute renal failure during cephalothin therapy . JAMA 229:679-682, 1974.Crossref 2. Fillastre JP, Laumonier R, Humbert G, et al: Acute renal failure associated with combined gentamicin and cephalothin therapy . Br Med J 2:396-397, 1973.Crossref 3. Bobrow SN, Jaffe E, Young RC: Anuria and acute tubular necrosis associated with gentamicin and cephalothin . JAMA 222:1546-1547, 1972.Crossref 4. Schultze RG, Winters RE, Kauffman H: Possible nephrotoxicity of gentamicin . J Infect Dis 124:5145-5147, 1971.Crossref 5. Kahn T, Stein RM: Gentamicin and renal failure . Lancet 1:498, 1972.Crossref 6. Milman N: Renal failure associated with gentamicin therapy . Acta Med Scand 196:87-91, 1974.Crossref 7. Kerr D: Phenacetin nephropathy . Br Med J 4:363-364, 1970.Crossref 8. Krikler DM: Paracetamol and the kidney . Br Med J 2:615-616, 1967.Crossref 9. Master DR: Analgesic nephropathy associated with paracetamol . Proc Roy Soc Med 66:904, 1973. 10. Prescot LF: Effects of acetylsalicylic acid, phenacetin, paracetamol and caffeine on renal tubular epithelium . Lancet 2:91-96, 1965.Crossref 11. Schreiner GE, Maher JF: Toxic nephropathy . Am J Med 38:409-449, 1965.Crossref 12. Wong EGC, Rowe PH, Blumenkrantz MJ, et al: Nephrotoxicity associated with use of methoxyflurane: Recovery following severe renal impairment . Nephron 13:174-182, 1974.Crossref 13. Panner BJ, Freeman RB, Roth-Mayo LA, et al: Toxicity following methoxyflurane anesthesia: I. Clinical and pathological observations in two fatal cases . JAMA 214:86-90, 1970.Crossref 14. Campese VM, Marzullo F, Schena FP, et al:. Acute renal failure during intermittent rifampicin therapy . Nephron 10:256-261, 1973.Crossref 15. Gold LW, Sellers A. Fishman M: Acute renal failure related to gentamicin therapy , abstracted. Am Soc Nephrol 4:27, 1971. 16. Wilfert JN, Burke JP, Bloomer HA, et al: Renal insufficiency associated with gentamicin therapy . J Infect Dis 124:5148-5153, 1971.Crossref 17. Flandre 0, Damon M: Experimental study of the nephrotoxicity of gentamicin in rats , in Gentamicin: First International Symposium . Lucerne, Switzerland, Essex Chemie AG, 1967, pp 17-61. 18. Rosenthal SL: Aminoglycoside antibiotics . NY State J of Med 75:535-545, 1975. 19. Black J. Calesnick B, Williams D, et al: Pharmacology of gentamicin: A new broad-spectrum antibiotic , in Sylvester JC (ed): Antimicrobial agents and Chemotherapy . Ann Arbor, Mich, American Society for Microbiology, 1963, pp 138-147. 20. Welton A. Walker WG: Intrarenal antibiotic distribution in health and disease . Kidney Int 6:131-137, 1974.Crossref 21. Kosek JC, Mazze RI, Cousins MJ: Nephrotoxicity of gentamicin . Lab Invest 30:48-57, 1974. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Gentamicin-Associated Acute Renal Failure

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Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1976.03630100019007
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Abstract

Abstract Five patients are described in whom only gentamicin sulfate appeared responsible for acute renal failure. Subjects received 1.2 to 2.88 gm over 12 to 18 days. All were over 45 years of age, and premorbid kidney abnormalities may have enhanced susceptibility to toxic effects of the drug. Renal failure appeared 8 to 17 days after beginning gentamicin therapy and was characterized by creatinine clearances 4 to 10 ml/min, urine to plasma creatinine ratios < 20, urinary sodium concentrations 16 to 60 mEq/ liter, proteinuria, and cylindruria. Oliguria was not observed and this feature may impair recognition of kidney damage. Clinical recovery required an average of 42 days and was complete in four of five patients. Gentamicin alone may be nephrotoxic and should be given with particular caution to the elderly and those with even mild kidney abnormalities. (Arch Intern Med 136:1101-1104, 1976) References 1. Burton JR, Lichenstein NS, Colvin RB, et al: Acute renal failure during cephalothin therapy . JAMA 229:679-682, 1974.Crossref 2. Fillastre JP, Laumonier R, Humbert G, et al: Acute renal failure associated with combined gentamicin and cephalothin therapy . Br Med J 2:396-397, 1973.Crossref 3. Bobrow SN, Jaffe E, Young RC: Anuria and acute tubular necrosis associated with gentamicin and cephalothin . JAMA 222:1546-1547, 1972.Crossref 4. Schultze RG, Winters RE, Kauffman H: Possible nephrotoxicity of gentamicin . J Infect Dis 124:5145-5147, 1971.Crossref 5. Kahn T, Stein RM: Gentamicin and renal failure . Lancet 1:498, 1972.Crossref 6. Milman N: Renal failure associated with gentamicin therapy . Acta Med Scand 196:87-91, 1974.Crossref 7. Kerr D: Phenacetin nephropathy . Br Med J 4:363-364, 1970.Crossref 8. Krikler DM: Paracetamol and the kidney . Br Med J 2:615-616, 1967.Crossref 9. Master DR: Analgesic nephropathy associated with paracetamol . Proc Roy Soc Med 66:904, 1973. 10. Prescot LF: Effects of acetylsalicylic acid, phenacetin, paracetamol and caffeine on renal tubular epithelium . Lancet 2:91-96, 1965.Crossref 11. Schreiner GE, Maher JF: Toxic nephropathy . Am J Med 38:409-449, 1965.Crossref 12. Wong EGC, Rowe PH, Blumenkrantz MJ, et al: Nephrotoxicity associated with use of methoxyflurane: Recovery following severe renal impairment . Nephron 13:174-182, 1974.Crossref 13. Panner BJ, Freeman RB, Roth-Mayo LA, et al: Toxicity following methoxyflurane anesthesia: I. Clinical and pathological observations in two fatal cases . JAMA 214:86-90, 1970.Crossref 14. Campese VM, Marzullo F, Schena FP, et al:. Acute renal failure during intermittent rifampicin therapy . Nephron 10:256-261, 1973.Crossref 15. Gold LW, Sellers A. Fishman M: Acute renal failure related to gentamicin therapy , abstracted. Am Soc Nephrol 4:27, 1971. 16. Wilfert JN, Burke JP, Bloomer HA, et al: Renal insufficiency associated with gentamicin therapy . J Infect Dis 124:5148-5153, 1971.Crossref 17. Flandre 0, Damon M: Experimental study of the nephrotoxicity of gentamicin in rats , in Gentamicin: First International Symposium . Lucerne, Switzerland, Essex Chemie AG, 1967, pp 17-61. 18. Rosenthal SL: Aminoglycoside antibiotics . NY State J of Med 75:535-545, 1975. 19. Black J. Calesnick B, Williams D, et al: Pharmacology of gentamicin: A new broad-spectrum antibiotic , in Sylvester JC (ed): Antimicrobial agents and Chemotherapy . Ann Arbor, Mich, American Society for Microbiology, 1963, pp 138-147. 20. Welton A. Walker WG: Intrarenal antibiotic distribution in health and disease . Kidney Int 6:131-137, 1974.Crossref 21. Kosek JC, Mazze RI, Cousins MJ: Nephrotoxicity of gentamicin . Lab Invest 30:48-57, 1974.

Journal

Archives of Internal Medicine – American Medical Association

Published: Oct 1, 1976

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