Amikacin nephrotoxicity. Incidence, clinical course and risk factors. a prospective study in a teaching hospital
Gamba, G.; Arizpe, D.; Ferral, H.; Contreras, A.M.; Cortés, J.; Mendoza, A.; Malé, R.; Viniegra, L.; Peña, J.C.
Revista de Investigacion Clinica; Organo del Hospital de Enfermedades de la Nutricion 40(2): 135-140
1988
ISSN/ISBN: 0034-8376 PMID: 3175367 Document Number: 3770
Two hundred forty nine patients under treatment with intravenous amikacin alone, or in combination with other antibiotics, were followed prospectively to determine the incidence, clinical course and risk factors of nephrotoxicity secondary to the use of this drug. The group of study included 123 males and 126 females with mean age -±- SD of 47±- 8.5 years. Seven patients received amikacin alone, 194 associated to another antibiotic, and 48 as part of a three drug regimen. Baseline serum creatinine were 1.08±0.48 mg/dl and calculated creatinine clearance was 99±45 ml/min. Serum creatinine levels were obtained every-other day and amikacin through levels once weekly. Twenty-five patients developed renal toxicity, for an incidence of 10%. In all cases, the clinical course was benign, except in one with severe acute renal failure of the non-oliguric type. Male sex, old age and low serum albumin levels were found as the main risk factors of renal toxicity. Patients with diabetes, mellitus, chronic liver disease, female sex, connective tissue disease, concomitant use of cephalotin, and prolonged treatment duration did not show an increased risk of amikacin nephrotoxicity.
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