Glomerular nephrotoxicity of aminoglycosides

Toxicol Appl Pharmacol. 2007 Aug 15;223(1):86-98. doi: 10.1016/j.taap.2007.05.004. Epub 2007 May 21.

Abstract

Aminoglycoside antibiotics are the most commonly used antibiotics worldwide in the treatment of Gram-negative bacterial infections. However, aminoglycosides induce nephrotoxicity in 10-20% of therapeutic courses. Aminoglycoside-induced nephrotoxicity is characterized by slow rises in serum creatinine, tubular necrosis and marked decreases in glomerular filtration rate and in the ultrafiltration coefficient. Regulation of the ultrafiltration coefficient depends on the activity of intraglomerular mesangial cells. The mechanisms responsible for tubular nephrotoxicity of aminoglycosides have been intensively reviewed previously, but glomerular toxicity has received less attention. The purpose of this review is to critically assess the published literature regarding the toxic mechanisms of action of aminoglycosides on renal glomeruli and mesangial cells. The main goal of this review is to provide an actualized and mechanistic vision of pathways involved in glomerular toxic effects of aminoglycosides.

Publication types

  • Review

MeSH terms

  • Aminoglycosides / adverse effects*
  • Animals
  • Anti-Bacterial Agents / adverse effects*
  • Apoptosis / drug effects
  • Gentamicins / adverse effects
  • Glomerular Filtration Rate
  • Humans
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / metabolism
  • Kidney Diseases / pathology
  • Mesangial Cells / drug effects*
  • Mesangial Cells / pathology

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents
  • Gentamicins