KIDNEY DAMAGE

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Kidney damage associated with gentamicin use:

Gentamicin is toxic to certain kidney cells. It is excreted in the urine, which results in the kidney cells of a person being treated with gentamicin being almost constantly bathed in gentamicin. When gentamicin is given for too long, or at too high a dose, progressive kidney failure frequently occurs. As the kidneys fail, less gentamicin is excreted. This leads to a higher concentration of gentamicin in the bloodstream, which may further damage the kidneys. Once the kidney begins to fail in a person receiving gentamicin, further kidney damage may quickly ensue if the gentamicin dose is not adjusted or discontinued. Kidney failure induced by gentamicin is often reversible, or partially reversible, unlike most of gentamicin’s other side effects.

Symptoms of kidney damage:

According to Mayoclinic.com, signs of kidney damage can include:

• Decreased urine output, although occasionally urine output remains normal
• Fluid retention, causing swelling in your legs, ankles or feet
• Drowsiness
• Shortness of breath
• Fatigue
• Confusion
• Seizures or coma in severe cases
• Chest pain related to pericarditis, an inflammation of the sac-like membrane that envelops your heart

Most people who are on gentamicin do not experience these symptoms until late in the process. Therefore, it is critical that kidney function be measured to detect early nephrotoxicity.  

See articles and resources listed below for more details and information:  

Renal (kidney) physiology and pathophysiology:

• Frundenruch CC.  How your Kidneys work
• University of Utah.  Overview of Renal Function

Aminoglycoside induced renal damage:

• Mingeot-Leclercq MP and Tulkens PM.  Aminoglycosides: Nephrotoxicity
• Akinbodewa AA and Okunola O.  Concomitant gentamicin-induced nephrotoxicity and bilateral ototoxicity
• Prayle A and others.  Side effects of aminoglycosides on the kidney, ear and balance in cystic fibrosis
• Udupa V and Prakash V.  Gentamicin induced acute renal damage and its evaluation using urinary biomarkers in rats