Renal safety of short-term empiric gentamicin therapy in aged patients

Australas J Ageing. 2018 Sep;37(3):227-231. doi: 10.1111/ajag.12541. Epub 2018 Apr 27.

Abstract

Objective: To determine the incidence of acute kidney injury (AKI) in aged patients receiving empiric gentamicin therapy.

Methods: Patients aged ≥65 years receiving gentamicin upon admission between 2013 and 2015 at two Australian hospitals were retrospectively studied. AKI was defined as a rise in creatinine by ≥50% and/or ≥26.5 μmol/L.

Results: Most patients (95%) received a single dose of gentamicin. The incidence of AKI was 15% (36/242 patients). A composite outcome of persistent kidney injury, requirement for renal replacement therapy or inpatient death in a patient with AKI occurred in 10 (4%) patients. Patients who developed AKI were older (median 80.5 vs 78 years, P = 0.03), had higher Charlson Co-morbidity Index (median 7 vs 5, P = 0.0004) and had more advanced chronic kidney disease at baseline (Stages IV and V) (OR 4.38, 95% confidence interval 1.45-13.2, P = 0.01).

Conclusion: Empiric gentamicin use in patients with advancing age is associated with low rates of predominantly transient renal impairment.

Keywords: acute kidney injury; aminoglycosides; gentamicin; nephrology.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / mortality
  • Acute Kidney Injury / therapy
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Biomarkers / blood
  • Creatinine / blood
  • Female
  • Gentamicins / administration & dosage
  • Gentamicins / adverse effects*
  • Hospital Mortality
  • Humans
  • Incidence
  • Kidney / drug effects*
  • Kidney / metabolism
  • Kidney / physiopathology
  • Male
  • Patient Admission
  • Renal Replacement Therapy
  • Retrospective Studies
  • Risk Factors
  • Up-Regulation
  • Victoria / epidemiology

Substances

  • Anti-Bacterial Agents
  • Biomarkers
  • Gentamicins
  • Creatinine