The effect of oxytetracycline in pregnancy complicated by glomerular nephritis: A case study

Abstract

To a pregnant patient with chronic glomerular nephritis oxytetracycline has been orally administered in doses of 2 to 3.5 Gm. daily for periods of 3 days to 5 weeks. Its administration was started when the patient began showing an increased output of urinary protein at 20 weeks' gestation, it having been ascertained that this increase was not associated with any infectious process. From the twentieth to the thirty-fourth weeks of gestation, when pregnancy was terminated, the influence of terramycin upon albuminuria, the urinary metabolites of progesterone, urinary creatin, potassium, sodium, and fluid balance, upon tubular resorption of electrolytes, and upon serum nonprotein nitrogen, proteins, sodium, potassium, and chlorides was investigated. Terramycin therapy was periodically interrupted in order to be sure any changes observed were due to its administration. The experiment was repeated during the first 12 postpartum days. The following changes resulted from OTC administration during pregnancy: (1) decreased albuminuria and a rise in the albumin to globulin ratio of the serum; (2) increased creatinuria; (3) a rise in serum nonprotein nitrogen when more than 2 Gm. of Terramycin was given daily; (4) increased urinary output of potassium with a suggestive rise in the level of serum potassium and evidence for decreased tubular resorption of potassium; (5) diuresis at periods that had been preceded by fluid retention, with increased urinary output of sodium and evidence for decreased tubular resorption of sodium; (6) a change in the urinary metabolites of progesterone indicative of a more normal metabolism of available progesterone, and a marked increase in pregnanediol output coincident with a pronounced lowering of urinary protein.During the postpartum period the changes in creatinuria, nonprotein nitrogen, and the urinary output of fluid and electrolytes were equally marked during OTC administration. Albuminuria and the A-G ratio of serum proteins, however, were not significantly influenced at this time.