Phillips M E, Eastwood J B, Curtis J R, Gower P C, De Wardener H E
Br Med J. 1974 Apr 20;2(5911):149-51. doi: 10.1136/bmj.2.5911.149.
Seven cases are reported in which drugs of the tetracycline group produced a fall in the glomerular filtration rate. In six patients there was a primary underlying renal disease and renal impairment. All seven patients were made seriously ill by the antibiotic. Two patients required immediate haemodialysis; one died and the other continued on dialysis until transplanted. Another patient initially responded to intravenous fluids and protein restriction but his renal function deteriorated and four months later he began maintenance haemodialysis. Three patients required peritoneal dialysis. The seventh patient responded satisfactorily to conservative management. The medical and medicolegal complications arising from the use of tetracycline in patients with renal disease are discussed. Yet another plea is made that drugs of the tetracycline group other than doxycycline should not be given to patients with chronic renal failure.
报告了7例四环素类药物导致肾小球滤过率下降的病例。其中6例患者存在原发性基础肾脏疾病和肾功能损害。所有7例患者均因使用该抗生素而病情严重。2例患者需要立即进行血液透析;1例死亡,另1例在移植前持续进行透析。另1例患者最初对静脉输液和蛋白质限制治疗有反应,但肾功能恶化,4个月后开始维持性血液透析。3例患者需要进行腹膜透析。第7例患者对保守治疗反应良好。文中讨论了肾病患者使用四环素所引发的医学及法医学并发症。再次呼吁,除强力霉素外,四环素类药物不应给予慢性肾衰竭患者。