Pharmacokinetics of gentamicin in patients with various levels of diabetic proteinuria.
Diabetic nephropathy is a relatively common medical problem. The effects of early-stage nephropathy on the kinetic disposition of renally cleared drugs have received little attention. This study evaluated single-dose pharmacokinetics of gentamicin in 15 patients with various levels of diabetic proteinuria who had relatively normal serum creatinine concentrations. These pharmacokinetic parameters were compared with predicted parameters based on the method used clinically in our institution. The correlation between the amount of proteinuria and each of the pharmacokinetic parameters was also evaluated. The patients evaluated in this series had a gentamicin volume of distribution (P < 0.05) and half-life (P < 0.05) significantly higher than predicted and a gentamicin clearance (P < 0.01) significantly lower than predicted. A significant correlation between the amount of proteinuria and the measured pharmacokinetic parameters was not observed. These findings suggest that patients with diabetic proteinuria should be monitored closely when treated with aminoglycosides.
White
J R
JR
College of Pharmacy, Washington State University, Spokane.
Freerksen
A
A
Gould
B
B
Sclar
D A
DA
D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D003928:Diabetic Nephropathies / Q000378:metabolism*; D005260:Female; D005839:Gentamicins / Q000493:pharmacokinetics*; D006207:Half-Life; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000378:metabolism*
D005839:Gentamicins; D003404:Creatinine