Urinary biomarkers in assessing the nephrotoxic potential of gentamicin in solitary kidney patients after 7 days of therapy. (May 2014)

• Record Type: Journal Article
• Authors: Gluhovschi, Gheorghe; Gadalean, Florica; Gluhovschi, Cristina; Velciov, Silvia; Petrica, Ligia; Bob, Flaviu; Bozdog, Gheorghe; Kaycsa, Adriana
• Is Part Of: Renal failure. Volume 36:Number 4(2014)
• Page Start: 534
• Page End: 540
• Publication Date: 2014-05
• Subjects: Chronic renal failure -- Periodicals; Acute renal failure -- Periodicals; Uremia -- Periodicals; 616.614005
• DOI: 10.3109/0886022X.2013.876349
• Languages: English
• ISSNs: 0886-022X

Abstract

<abstract> <title>Abstract</title> <p> <italic>Introduction</italic>: The solitary kidney (SK) may present increased vulnerability to nephrotoxicity because of adaptive phenomena. <italic>Aims</italic>: Assessing the vulnerability of the SK with urinary tract infections (UTI) to gentamicin by means of urinary biomarkers (<italic>N-acetyl-beta-D-glucosaminidase</italic> (NAG) and urinary alpha-1-microglobulin), as well as glomerular filtration rate (GFR). <italic>Methods</italic>: We studied 14 patients with SK with UTI (group A) (mean age 58.07 ± 13.61 years, mean duration of SK 13.55 ± 12.33 years) who were administered gentamicin for 7 days. Group B consisted by 17 patients with SK without any other associated renal pathology (average age 51.17 ± 9.39 years, average existence period of a single kidney 33.23 ± 21.73 years). We also included a third group (group C) represented by nine healthy individuals, with two kidneys. <italic>Results</italic>: Increased values of urinary NAG were found in group B as compared to group C and alpha-1 microglobulin in group A as compared to group B. During treatment with gentamicin, increased values of both NAG and alpha-1-microglobulin in group A were found on day 7 as compared to values before treatment (day 7 NAG = 18.99 ± 14.07 U/g creat versus day 0, NAG = 5.15 ± 6.54 U/g creat, <italic>p = </italic>0.004; day 7 alpha-1-microglobulin = 20.88 ± 18.84 mg/g creat versus day 0, urinary alpha-1-microglobulin = 4.96 ± 6.57 mg/g creat, <italic>p = </italic>0.003). No statistically significant alterations of GFR were noticed after 7 days of treatment. <italic>Conclusions</italic>: We found the nephrotoxic effects of gentamicin at tubular level, but not at glomerular level. The nephrotoxic potential of gentamicin in patients with a SK can be monitored by assessing urinary biomarkers during treatment of UTI.</p> </abstract>