Skip to main content
SpringerLink
Log in

Evaluation of antibiotic-induced nephrotoxicity in preterm neonates by determining urinary α1-microglobulin

  • Brief Report
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

α1-Microglobulin (α1-m, protein HC), a relatively low molecular weight protein of about 31,000 daltons, was measured in urine of three groups of 34 preterm neonates: group A consisted of 9 healthy preterm neonates; groups B (n=13) and C (n=12) consisted of preterm neonates with suspected or confirmed bacterial infections. Immediately after birth, all group B neonates were treated with ampicillin and aztreonam in combination, and all group C neonates were treated with oxacillin and amikacin in combination. To optimize amikacin administration, computerized individually tailored doses were administered. Urine samples were obtained from a short collection in sterile bags on the 1 st, 4th, and 7th day after delivery in all infants. Urinary α1-m concentrations were measured by a turbidimetric method (latex agglutination photometric immunoassay) and results were expressed as a ratio to urinary creatinine. In group A, urinary α1-m concentrations were stable after birth. In group C, α1-m excretion increased immediately within the 1 st day of treatment, and over the 1st week of life urinary α1-m levels were significantly higher than in group A (P=0.033). These data support the conclusion that amikacin administration was the most important factor inducing renal tubular dysfunction in the neonates of group C.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Schwartz GJ, Brion LC, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children and adolescents. Pediatr Clin North Am 343: 571–590

    Google Scholar 

  2. IPCS CEC (International Programme on Chemical Safety, Commission of the European Communities) (1991) Principle and methods for the assessment of nephrotoxicity associated with exposure to chemicals. Environmental Health Criteria 119, WHO, Geneva

    Google Scholar 

  3. Jung K (1994) Urinary enzymes and low molecular weight proteins as markers of tubular dysfunction. Kidney Int 46 [Suppl 47]: 29–33

    Google Scholar 

  4. Donaldson MDC, Chambers RE, Woolridge W (1992) Stability of alphal-microglobulin, beta2-microglobulin and retinol binding protein in urine. Clin Chim Acta 179: 73–79

    Article  Google Scholar 

  5. Weber MH, Verwiebe R (1992) α1-Microglobulin (protein HC): features of a promising indicator of proximal tubular dysfunction. Eur J Clin Chem Clin Biochem 30: 683–691

    PubMed  CAS  Google Scholar 

  6. Padovani EM, Fanos V, Mussap M, Plebani M, Burlina A (1994) Enzyme and tubular protein contents in amniotic fluid. Eur J Obstet Gynecol Reprod Biol 55: 129–133

    Article  PubMed  CAS  Google Scholar 

  7. Padovani EM, Fanos V, Mussap M, Plebani M (1992) Neonatal tubular proteinuria: urinary alpha-1-microglobulin. UP 18: 323–325

    Google Scholar 

  8. Tsukahara H, Hiraoka M, Kuriyama M, Saito M, Morikawa K, Kuroda M, Tominaga T, Sudo M (1993). Urinary alphal-microglobulin as an index of proximal tubular function in early infancy. Pediatr Nephrol 7: 199–201

    Article  PubMed  CAS  Google Scholar 

  9. Tsukahara H, Hiraoka M, Kuryama M, Haruki S, Nakamura K, Suelniro F, Sudo M (1993) Evaluation of proximal tubular function in preterm infants by urinary alphal-microglobulin. Acta Paediatr Jpn Overseas Ed 35: 127–129

    CAS  Google Scholar 

  10. Fanos V, Pistolesi C, Rugolotto S, Khoory BJ, Martini N, Padovani EM (1993) Aminoglycosides in preterm newborn: computerized optimization of therapy. J Chemother 55 [Suppl 1]: 463–464

    Google Scholar 

  11. Padovani EM, Pistolesi C, Fanos V, Messori A, Martini N (1993) Pharmacokinetics of amikacin in neonates. Dev Pharmacol Ther 20: 167–173

    PubMed  CAS  Google Scholar 

  12. Kakishima H, Umezawa K, Kubota N, Oka J, Tsubota N, Morita K, Korozumi T, Takahashi Y, Matsuzaki S (1983) Study on latex agglutination photometric assay with LA System (Automatic Immunochemical Analyzer) 1. JJCLA 8: 156–160

    Google Scholar 

  13. Myers JL (ed) (1979) Fundamentals of experimental design. Allyn and Bacon, Boston

    Google Scholar 

  14. Cuzzolin L, Fanos V, Zambreri D, Benoni G, Padovani EM (1991) The pharmacokinetics and renal tolerance of aztreonam in premature infants. Antimicrob Agents Chemother 35: 1726–1728

    PubMed  CAS  Google Scholar 

  15. Tencer J, Thysell H, Andersson K, Grubb A (1994) Stability of albumin, protein HC, immunoglobulin G, κ- and λ-chain im-munoreactivity, orosomucoid and α1-antitripsin in urine stored at various conditions. Scand J Clin Lab Invest 54: 199–206

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Verona, Verona, Italy

    Vassilios Fanos & Ezio Maria Padovani

  2. Department of Laboratory Medicine, University of Padua, Padua, Italy

    Michele Mussap & Mario Plebani

  3. Institute of Medical Statistics, University of Verona, Verona, Italy

    Giuseppe Verlato

  4. Center of Biomedical Research, University of Padua, Castelfranco Veneto, Italy

    Mario Plebani

Authors
  1. Vassilios Fanos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michele Mussap
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giuseppe Verlato
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mario Plebani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ezio Maria Padovani
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fanos, V., Mussap, M., Verlato, G. et al. Evaluation of antibiotic-induced nephrotoxicity in preterm neonates by determining urinary α1-microglobulin. Pediatr Nephrol 10, 645–647 (1996). https://doi.org/10.1007/s004670050181

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s004670050181

Key words

Search

Navigation