Urinary alanine aminopeptidase and beta 2-microglobulin as measurements of aminoglycoside-associated renal impairment.
The value of urinary alanine aminopeptidase (AAP) and urinary beta 2-microglobulin as predictors of aminoglycoside-associated nephrotoxicity was studied in 46 patients treated with gentamicin or tobramycin. In three patients serum creatinine increased by more than 50 mumol/l. Urinary AAP increased in virtually all patients. The degree of these increases could not be correlated to subsequent increases in serum creatinine. Increases in urinary beta 2-microglobulin were also seen in many patients who did not show subsequent increases in serum creatinine. Moreover, urinary beta 2-microglobulin was elevated before the onset of aminoglycoside treatment in many patients with septicaemia and malignant diseases, thus making an evaluation of antibiotic-induced changes impossible. These results indicate that neither urinary AAP nor urinary beta 2-microglobulin can be used to predict aminoglycoside-associated nephrotoxicity of clinical importance in individual patients.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000009:adverse effects; D000626:Aminopeptidases / Q000652:urine*; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D018826:CD13 Antigens; D003404:Creatinine / Q000097:blood; D005260:Female; D005839:Gentamicins / Q000009:adverse effects; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000652:urine; D008297:Male; D008875:Middle Aged; D014031:Tobramycin / Q000009:adverse effects; D001613:beta 2-Microglobulin / Q000652:urine*
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D005839:Gentamicins; D001613:beta 2-Microglobulin; D003404:Creatinine; D000626:Aminopeptidases; D018826:CD13 Antigens; D014031:Tobramycin