Glomerular nephrotoxicity of aminoglycosides.
Aminoglycoside antibiotics are the most commonly used antibiotics worldwide in the treatment of Gram-negative bacterial infections. However, aminoglycosides induce nephrotoxicity in 10-20% of therapeutic courses. Aminoglycoside-induced nephrotoxicity is characterized by slow rises in serum creatinine, tubular necrosis and marked decreases in glomerular filtration rate and in the ultrafiltration coefficient. Regulation of the ultrafiltration coefficient depends on the activity of intraglomerular mesangial cells. The mechanisms responsible for tubular nephrotoxicity of aminoglycosides have been intensively reviewed previously, but glomerular toxicity has received less attention. The purpose of this review is to critically assess the published literature regarding the toxic mechanisms of action of aminoglycosides on renal glomeruli and mesangial cells. The main goal of this review is to provide an actualized and mechanistic vision of pathways involved in glomerular toxic effects of aminoglycosides.
Martínez-Salgado
Carlos
C
Unidad de Investigación, Hospital Universitario de Salamanca, Paseo San Vicente 58-182, 37007 Salamanca, Spain. carlosms@usal.es
López-Hernández
Francisco J
FJ
López-Novoa
José M
JM
D000617:Aminoglycosides / Q000009:adverse effects*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D017209:Apoptosis / Q000187:drug effects; D005839:Gentamicins / Q000009:adverse effects; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000378:metabolism / Q000473:pathology; D050527:Mesangial Cells / Q000187:drug effects* / Q000473:pathology
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D005839:Gentamicins