Cystic fibrosis,aminoglycoside treatment and acute renal failure: the not so gentle micin |
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Authors: | Detlef Bockenhauer Martin J Hug Robert Kleta |
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Institution: | (1) Paediatric Nephrology, Great Ormond Street Hospital, Great Ormond Street, London, WC1 3JH, UK;(2) Pharmacy, University Hospital Freiburg, Freiburg, Germany;(3) Centre for Nephrology, University College London, London, UK |
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Abstract: | Aminoglycosides have a wide spectrum of gram-negative anti-bacterial activities and are available at low cost, which makes
them commonly used drugs, especially for patients with cystic fibrosis (CF), who often suffer from chronic lung infections
from Pseudomonas aeruginosa. Unfortunately, this treatment seems to have resulted in an increased incidence of acute renal failure (ARF) in patients
with CF. A recent case–control study investigated risk factors for ARF in CF patients and suggested intravenous use of gentamicin
as the prime culprit. Moreover, in most cases, at least one other risk factor, such as CF-related diabetes, pre-existing renal
failure, dehydration or concurrent use of other nephrotoxic drugs, was present. We comment on the renal handling of aminoglycosides
and the possible mechanisms of toxicity, as well as strategies for risk minimisation. |
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Keywords: | Cystic fibrosis Aminoglycoside Gentamicin Acute renal failure Children |
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