Glomerular filtration rate aminoglycosides

Example. Kanamycin is a member of the aminoglycoside class of antibiotics, all of which are eliminated exclusively by glomerular filtration. Creatinine is a natural body substance that is cleared almost exclusively by glomerular filtration, and creatinine clearance rate is frequently used as a diagnostic tool to determine glomerular filtration rate. The relationship... 

The most important and common acute toxicity caused by aminoglycoside treatment is renal dysfunction or nephrotoxicity, and comprehensive review articles on the molecular mechanisms of nephrotoxicity of aminoglycosides have been published [205,206,207]. Clinically, renal toxicity is manifested by the increase of blood urea and serum creatinine levels, as well as by alteration of the glomerular filtration rate (GFR). Although the effects of aminoglycosides on the kidney are reversible and rarely cause death, since renal clearance is affected, kidney dysfunction leads to complications in patients who are on multiple drugs and in other hospitalized patients. 

Gentamicin was found to induce an activation of cultured mesangial cells, as measured by contraction (PCSA) and proliferation. Since gentamicin increases the expression of inducible nitric oxide (iNOS) in these cells [202] and has been shown to elevate intracellular Ca + (via influx, and release from internal stores) [203], it is postulated that nitric oxide-induced Ca2+ elevation might be responsible for the observed effect. These results are in support of a mesangial cell role in the reduction of glomerular filtration rate after aminoglycoside intoxication [204, 205]. 

Urinary tract In 306 consecutive patients starting aminoglycoside therapy in an ITU-independent susceptibility factors for aminoglycoside-associated nephrotoxicity were a baseline estimated glomerular filtration rate (eGFR) under 60 mFminute/ 1.73 m, diabetes mellitus, treatment with other nephrotoxic drugs or iodinated contrast agents, and hypotension [5 ]. 

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