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Functional Considerations in Aminoglycoside Nephrotoxicity

  • William M. Bennett
  • Donald C. Houghton
  • W. Clayton Elliott

Abstract

Aminoglycoside nephrotoxicity is a relatively common clinical problem. Well-controlled studies have documented up to a 26% incidence of serum creatinine elevations during therapy despite monitoring by frequent aminoglycoside blood level determinations (Smith et al., 1980). Because of the complex clinical settings in which these antibiotics are prescribed, efforts to study the pathophysiology of nephrotoxicity have involved use of animal models (Kosek et al., 1974; Luft et al., 1975; Houghton et al., 1976; Cronin et al., 1980). In this chapter, an attempt will be made to correlate findings in one such model, the rat, with certain variables which may influence aminoglycoside nephrotoxicity. It has become apparent that studies concerning biochemical and subcellular mechanisms of aminoglycoside nephrotoxicity must take into account the considerable regenerative and functional recovery which occurs during continuous treatment with aminoglycosides. It is not clear at present whether similar caution needs to be exercised in interpreting studies involving other nephrotoxins which cause experimental or clinical acute renal failure. Finally, the consequences of acute nephrotoxic insults on long-term renal functional integrity should be carefully evaluated despite return to normal of such insensitive parameters as serum creatinine after the toxin is withdrawn.

Keywords

Acute Renal Failure Inulin Clearance Renal Cortical Slice Aminoglycoside Nephrotoxicity Gentamicin Nephrotoxicity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1982

Authors and Affiliations

  • William M. Bennett
    • 1
  • Donald C. Houghton
    • 1
  • W. Clayton Elliott
    • 1
  1. 1.Division of Nephrology, Department of MedicineOregon Health Sciences UniversityPortlandUSA

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