Renal tubular sodium and water excretion in antibiotic-induced nephrotoxicity. Renal function in antibiotic nephrotoxicity.
Clearance techniques were used to evaluate renal tubular sodium and water excretion in 4 patients with antibiotic-induced acute renal failure (ARF). Creatinine clearances and maximal urine flow rates of patients with ARF (22.6 and 5.23 ml/min, respectively) were significantly lower than control values during hypotonic volume expansion (125.5 and 13.71 ml/min, respectively, both p less than 0.01). During the period of maximal hydration, fractional sodium excretion (CNa/Ccr) and maximal urine osmolality (11.4% and 171 mosm/kg H2O, respectively) were increased compared to controls (1.04% and 53 mosm/kg H2O, respectively, both p less than 0.05). The increased CNa/Ccr observed in patients with ARF was consistent with reduced proximal sodium reabsorption as reflected by increased (CH2O + CNa)/Ccr and reduced fractional distal sodium reabsorption as indicated by decreased  CH2O/(CH2O + CNa). The reduction in proximal and distal sodium reabsorption cannot be explained on the basis of an osmotic effect of urea as fractional clearances of BUN (CBUN/Ccr) were similar in patients with ARF and controls.
D058186:Acute Kidney Injury / Q000139:chemically induced*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001834:Body Water / Q000378:metabolism*; D002512:Cephalothin / Q000009:adverse effects; D003091:Colistin / Q000009:adverse effects; D005260:Female; D005839:Gentamicins / Q000009:adverse effects; D006801:Humans; D007612:Kanamycin / Q000009:adverse effects; D007684:Kidney Tubules / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012964:Sodium / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D007612:Kanamycin; D012964:Sodium; D002512:Cephalothin; D003091:Colistin