Krcméry V, Deák J, Kovác A, Gocár E, Menkyna R, Demes M, Pribylincová V, Vevercáková M, Stankovic I
Cas Lek Cesk. 1989 Jul 28;128(31):981-4.
The clinical course of eight case reports of patients with acute renal failure after administration of nephrotoxic antibiotics--specially of tetracycline and gentamycin--is demonstrated. All patients were suffering on preexisting nephropathy, many of them in stage of chronic renal failure according to various etiopathogenesis. As concomitant factor inducing acute renal failure together with antibiotics are: elderly, hepatopathy, surgical interventions, administration of other nephrotoxic drugs. In 6 patients, where acute renal failure induced by nonreducted doses of antibiotics appeared, the treatment was successful, in five cases due to short term haemodialysis, once conservatively with diuretics and volume diuresis. Two patients died before the therapeutic measures and dialysis could be performed. Algorithms in diagnosis and treatment of chronic renal failure--patients where antibiotic treatment is necessary are discussed.
本文展示了8例使用肾毒性抗生素(特别是四环素和庆大霉素)后发生急性肾衰竭患者的临床病程。所有患者均患有既往肾病,其中许多患者根据不同的病因病机处于慢性肾衰竭阶段。与抗生素一起诱发急性肾衰竭的伴随因素有:老年、肝病、外科手术、使用其他肾毒性药物。在6例因未减量使用抗生素而诱发急性肾衰竭的患者中,治疗取得成功,5例通过短期血液透析,1例采用利尿剂和容量利尿进行保守治疗。2例患者在能够实施治疗措施和透析之前死亡。文中讨论了慢性肾衰竭患者(需要进行抗生素治疗)的诊断和治疗方案。