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October 1976

Gentamicin-Associated Acute Renal Failure

Author Affiliations

From the Departments of Medicine, College of Medicine and Dentistry of New Jersey Rutgers Medical School, Piscataway, NJ, and St Vincent's Hospital and Medical Center of New York. Dr Buzzeo is now with the Department of Medicine, New York University School of Medicine, New York, and Dr Salaki is now with the Department of Medicine, College of Medicine and Dentistry of New Jersey-The New Jersey Medical School, Newark.

Arch Intern Med. 1976;136(10):1101-1104. doi:10.1001/archinte.1976.03630100019007

Five patients are described in whom only gentamicin sulfate appeared responsible for acute renal failure. Subjects received 1.2 to 2.88 gm over 12 to 18 days. All were over 45 years of age, and premorbid kidney abnormalities may have enhanced susceptibility to toxic effects of the drug. Renal failure appeared 8 to 17 days after beginning gentamicin therapy and was characterized by creatinine clearances 4 to 10 ml/min, urine to plasma creatinine ratios < 20, urinary sodium concentrations 16 to 60 mEq/ liter, proteinuria, and cylindruria. Oliguria was not observed and this feature may impair recognition of kidney damage. Clinical recovery required an average of 42 days and was complete in four of five patients. Gentamicin alone may be nephrotoxic and should be given with particular caution to the elderly and those with even mild kidney abnormalities.

(Arch Intern Med 136:1101-1104, 1976)

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