title: Use of aminoglycosides for peritoneal dialysis-associated peritonitis does not affect residual renal function.
abstract: BACKGROUND
  Aminoglycosides offer several potential benefits in their treatment of peritoneal dialysis (PD)-associated peritonitis, including low cost, activity against Gram-negative organisms (including Pseudomonas aeruginosa), synergistic bactericidal activity against some Gram-positive organisms (such as Staphylococci) and relatively low propensity to promote antimicrobial resistance. However, there is limited conflicting evidence that aminoglycosides may accelerate loss of residual renal function (RRF) in PD patients. The aim of this study was to study the effect of aminoglycoside use on slope of decline in RRF.
  
  
  METHODS
  The study included 2715 Australian patients receiving PD between October 2003 and December 2007 in whom at least two measurements of renal creatinine clearance were available. Patients were divided according to tertiles of slope of RRF decline (rapid, intermediate and slow). The primary outcome was the slope of RRF over time in patients who received aminoglycosides for PD peritonitis versus those who did not.
  
  
  RESULTS
  A total of 1412 patients (52%) experienced at least one episode of PD peritonitis. An aminoglycoside was used as the initial empiric antibiotic in 1075 patients. The slopes of RRF decline were similar in patients treated and not treated with at least one course of aminoglycoside (median [interquartile range] -0.26 [-1.17 to 0.04] mL/min/1.73 m(2)/month versus -0.22 [-1.11 to 0.01] mL/min/1.73 m(2)/month, P = 0.9). The slopes of RRF decline were also similar in patients receiving repeated courses of aminoglycoside.
  
  
  CONCLUSIONS
  Empiric treatment with aminoglycoside for peritonitis was not associated with an adverse effect on RRF in PD patients.
authors.affiliation: Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia.
authors.forename: Sunil V
authors.initials: SV
authors.lastname: Badve
authors.forename: Carmel M
authors.initials: CM
authors.lastname: Hawley
authors.forename: Stephen P
authors.initials: SP
authors.lastname: McDonald
authors.forename: Fiona G
authors.initials: FG
authors.lastname: Brown
authors.forename: Neil C
authors.initials: NC
authors.lastname: Boudville
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Wiggins
authors.forename: Kym M
authors.initials: KM
authors.lastname: Bannister
authors.forename: David W
authors.initials: DW
authors.lastname: Johnson
mesh_terms: D000617:Aminoglycosides / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors
chemical_list: D000617:Aminoglycosides