Abstract
The adverse renal effects of aminoglycosides are increasing, up to 20% in patients treated with this class of antibiotic, nephrotoxicity is manifested by the renal insufficiency with a variable degree, usually clinically silent but the return to the former state is not always obtained which progresses towards chronic kidney disease. After studying a declaration of an adverse case at the pharmacovigilance service of the UHE of Oran.The impact of nephrotoxicity of aminoglycosides in the aggravation of pre-existing renal insufficiency has been demonstrated according to the French and Anglo-Saxon method of accountability that is why information on pharmacological therapeutic monitoring of STP should be recommended. In conclusion, the knowledge of the factors favoring the nephrotoxicity of aminoglycosides, the respect of the dosages and the reduction of the duration of the treatment allows the practitioner to take measures in order to prevent and to reduce the frequency of the renal complications. The side effect of aminoglycoside therapy may occur in up to 20% of the exposed patients treated with this antibiotic class, this nephrotoxicity is manifested by varying degrees of renal insufficiency (IR), usually clinically silent but the return to the previous state is not always got, sometimes progress to chronic renal disease. Following the study of a case of adverse reaction reporting; has been shown by the French and Anglo-Saxon method of accountability, the impact of aminoglycosides’ nephrotoxicity in the aggravation of existing IR, why therapeutic drug monitoring TDM actualities are recommended. In conclusion, knowledge of predisposing factors nephrotoxicity of aminoglycosides, respect the doses and reducing the duration of treatment allows the practitioner to take measures in order to prevent and decrease the frequency of renal complications.
Highlights
Renal involvement of iatrogenic origin is a common occurrence in clinical practice and is often poorly understood
The patient was diagnosed with chronic end-stage renal insufficiency (IRCT), plasma creatinine at 90 mg/l corresponds to a creatinine clearance of 12.15 ml/ min according to Cockcroft; 7.17 ml/min MDRD and 6.81 ml/min CKD-EPI, requiring dialysis sessions
Renal impairment is usually acute, reversibility is not always obtained, and some of it progress towards chronic renal disease: lesions of interstitial fibrosis are frequently observed on the renal histological examination and it can lead to chronic end-stage renal insufficiency[2], and this is the case of our patient[11]
Summary
Renal involvement of iatrogenic origin is a common occurrence in clinical practice and is often poorly understood. This is a serious event that is associated with significant morbidity and mortality[1,2,3]. Aminoglycosides are widely used antibiotics; their major risk is the nephrotoxicity following the accumulation leading to a tubular necrosis. The adverse renal effects of aminoglycosides are increasing up to 20% in patients treated with this class of antibiotic; nephrotoxicity is manifested by the renal insufficiency with a variable degree[4]. The objective of this work is to demonstrate the impact of nephrotoxicity of aminoglycosides in the aggravation of a pre-existing renal failure, following the study of a case of adverse reaction
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