Aminoglycosides and renal acid excretion.
The effect of three aminoglycosides, gentamicin, netilmicin and amikacin, on renal acid excretion was studied in rats treated with doses equivalent to 10 times those used clinically. The gentamicin and amikacin groups showed a marked decrease (P less than 0.05), in glomerular filtration rate (GFR), U/P inulin ratio and renal plasma flow (RPF), while in the normal acid-base state. Under acidotic conditions, only gentamicin promoted significant alterations in GFR and RPF. Net acid excretion as measured by the acid balance (BH) was calculated as the sum of ammonium excretion (NH4+) and titratable acidity (AT) minus the amount of excreted bicarbonate (CHCO3-). Under normal conditions, netilmicin promoted a considerable fall in both NH4+ and AT, which led to a significant decrease in BH, whereas no changes were observed in these parameters with the other two drugs. In contrast, during acute metabolic acidosis, all tested antibiotics promoted a marked fall in BH, particularly due to a significant decrease in NH4+ and AT. These data suggest that the effects of aminoglycoside treatment during acute metabolic acidosis in clinical practice deserve further study in view of possible deleterious effects on the clinical state.
D000141:Acidosis, Renal Tubular / Q000209:etiology*; D000583:Amikacin / Q000494:pharmacology*; D000818:Animals; D005839:Gentamicins / Q000494:pharmacology*; D005919:Glomerular Filtration Rate / Q000187:drug effects; D007668:Kidney / Q000098:blood supply / Q000187:drug effects*; D008297:Male; D009428:Netilmicin / Q000494:pharmacology*; D051381:Rats
D005839:Gentamicins; D009428:Netilmicin; D000583:Amikacin