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Khirurgii

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Year 2009 Vol. 17 No 1

IN ASSISTANCE TO PRACTICIONER

BUSHMA K.M., SPAS V.V., SHAPEL I.A., GERASIMCHIK P.A., GRIGORUK A.V.

TO THE QUESTION OF AMINOGLYCOSIDES NEPHROTOXICITY

Aminoglycoside antibiotics play an important role in the antibacterial therapy of sepsis. Their administration is considerably limited by the risk of nephrotoxicity development (up to 25% cases). Science has several approaches concerning nephrotoxicity prevention based on the external factors management: single average daily dose administration, shortening of the therapy courses (not longer than 7 days), adequate hydratation, refusal to use other nephrotoxic agents during aminoglycoside course, kidney function control. However it has been cleared up that external factors stipulate for only 50% of nephrotoxicity. There are also internal, genetically grounded factors for aminoglycoside nephrotoxicity. They are: small diameter of proximal tubules and epithelial cells covering their lumen; high activity of lactatedehydrogenase, succinatdehydrogenase and acid phosphatase ensymopathias, small amount of ribonucleoproteins; reduced mitochondrial respiration capacity; active lipid peroxidation system; weak antioxidant potential. A low level of restored glutathione contributes considerably to nephrotoxicity realisation. At present some investigations are being carried on to develop the method of prevention of aminoglycoside nephrotoxicity influencing the internal risk factors.

Keywords: sepsis, antibiotics, aminoglycosides, nephrotoxicity.
p. 157 - 162 of the original issue
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