Aminoglycoside nephrotoxicity and its predictability.
Nephrotoxicity was evaluated in 37 patients receiving aminoglycosides by serial urinary measurements of the low-molecular weight protein beta 2-microglobulin (beta 2m) and the proximal tubular enzymes N-acetyl-glucosaminidase and beta-glucuronidase. Clinical nephrotoxicity, with a rise in serum creatinine greater than 20% of the baseline value, was diagnosed in 15 of 30 evaluable patients. The laboratory diagnosis of nephrotoxicity, defined as a two-fold increase in beta 2m, N-acetylglucosaminidase and beta-glucuronidase, was confirmed in 11/15 patients. Additionally, there were 3 patients in whom there was definitive laboratory nephrotoxicity in the absence of a rise in serum creatinine. The laboratory diagnosis of nephrotoxicity could be made 4.1--5.5 days prior to significant elevation in serum creatinine. The data suggest that beta 2m and enzyme studies are predictors of nephrotoxicity.
D000118:Acetylglucosaminidase / Q000652:urine; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000009:adverse effects*; D003404:Creatinine / Q000032:analysis; D005260:Female; D005966:Glucuronidase / Q000652:urine; D006801:Humans; D008297:Male; D008875:Middle Aged; D001613:beta 2-Microglobulin / Q000652:urine
D000617:Aminoglycosides; D001613:beta 2-Microglobulin; D003404:Creatinine; D005966:Glucuronidase; D000118:Acetylglucosaminidase