Non-oliguric renal failure in aminoglycoside nephrotoxicity.

ABSTRACT

Clinical and laboratory data were reviewed on 35 patients with acute renal failure associated with aminoglycoside administration. The diagnosis of nephrotoxicity was based on azotaemia both with or without a decline in the volume of urine. Clinical nephrotoxicity in these cases most likely occurred in association with surgery, advanced age, diabetes mellitus, jaundice and recent exposure to aminoglycosides. Twenty one of the 35 patients were non-oliguric. The duration of established renal failure after administion of aminoglycosides varied from 4 to 16 days. The common causative drugs were gentamicin (1.5-5 mg/kg/day) and kanamycin (1 gm/day) respectively. The maximum creatinine was 15 mg/dl. Conservative management of renal failure included withdrawal of aminoglycosides or adjusting the dose according to renal function, treatment of underlying diseases and provision of adequate hydration. Sixteen patients improved with normal serum creatinine within 7 days to 2 months after the onset of renal failure. Non of non-oliguric patients required dialysis treatment. Five patients died from septicaemia.