Antibiotic associated nephropathy.

Renal biopsies of 43 patients who developed renal complications after treatment with antibiotics were studied. The treatment with antibiotics in these cases was used for many different reasons such as: bronchitis, bronchopneumonia, cystitis, tonsillitis, sepsis, peritonitis, gangrene of the foot and tuberculosis. The renal function of these patients, before the treatment with antibiotics was normal. The biopsies were studied by light, electron and immunofluorescence microscopy. In 43 cases treated with antibiotics renal changes were shown. Three types of morphologic changes were found: acute tubular necrosis (ATN) (13 cases), acute tubulo-interstitial diseases (ATID) (21 cases), focal glomerulonephritis with crescents (FGN) (9 cases). The renal pathologic changes were most commonly seen in patients treated with 2 groups of antibiotics: aminoglycosides (21 cases) and antibiotics of the penicillin group (15 cases). The most characteristic feature of aminoglycosides is their direct toxic effect leading to ATN. Antibiotics of the penicillin type more commonly caused an allergic reaction leading to ATID (secondary to cellular mechanisms) or FGN (secondary to a predominantly humoral mechanism). Renal changes in the use of other antibiotics were much less manifest and were usually due to a hypersensitivity reaction. Cephalosporins, if used in combination with other antibiotics can increase their nephrotoxicity.

[The morphological characteristics of the nephrotic form of glomerulonephritis in children at puberty]. / Morfologicheskaia kharakteristika nefroticheskoi formy glomerulonefrita u detei pubertatnogo vozrasta.

67 children (from 3 to 18 years of age) and 26 adults (19-30-year-olds) with nephrotic or mixed forms of glomerulonephritis (GN) are studied. The most severe and pleiomorphic forms of GN are found in children of 12 to 15 years of age: mesangio-capillary, mesangial proliferative, extracapillary proliferative GN with "half-moon" structures, sclerosing GN. Pronounced disturbances of the vimentine content and distribution in the basal lamina, of i.v. type collagen, fibronectin in combination with its damage under the influence of various immune deposits (particularly subepithelial ones) are found in these patients.