Lucht F, Peyramond D, Robert D, Vincent P
Sem Hop. 1982 Sep 30;58(35):2021-5.
Mechanism of aminoglycoside nephrotoxicity is yet unclear. Reduction of 20 p. cent of glomerular filtration initial value is observed in 10 p. cent of cases. Aminoglycoside nephrotoxicity appears to be related to high doses, to duration of treatment and also to individual factors such as age and preexisting renal impairment. No mean of predicting aminoglycoside nephrotoxicity without any error is available. Meanwhile, accurate measurement of glomerular filtration and of beta 2-microglobulin urinary elimination seems clinically more usefull for detection of impaired renal function than uneasy measurement of urinary enzyme excretion and than monitoring the aminoglycosides serum concentrations.
氨基糖苷类药物肾毒性的机制尚不清楚。10%的病例中观察到肾小球滤过初始值降低了20%。氨基糖苷类药物肾毒性似乎与高剂量、治疗持续时间以及年龄和既往存在的肾功能损害等个体因素有关。目前尚无毫无误差地预测氨基糖苷类药物肾毒性的方法。同时,准确测量肾小球滤过和β2-微球蛋白的尿排泄量,在临床上对于检测肾功能损害似乎比测量尿酶排泄量这种麻烦的方法以及监测氨基糖苷类药物血清浓度更有用。