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Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Research Article

Assessing the Risk of Nephrotoxicity Associated with Aminoglycosides in Brucellosis Patients: A Cross-sectional Study

Author(s): Sara Ataei, Zeinab Ghodsipour, Fariba Keramat, Katayoun Derakhshandeh, Younes Mohammadi, Mohammad Mahdi Majzoobi, Masoumeh Kord, Mojdeh Mohammadi and Amir Nili-Ahmadabadi*

Volume 18, Issue 3, 2023

Published on: 20 August, 2022

Page: [355 - 360] Pages: 6

DOI: 10.2174/1574886317666220608145800

Price: $65

Abstract

Objective: The purpose of this study was to investigate renal function in patients with brucellosis before and at the end of gentamicin therapy. To ensure the safety of therapeutic doses of gentamicin, renal functions in brucellosis patients were monitored regarding drug serum levels and check for early detection biomarkers of nephrotoxicity.

Methods: In this cross-sectional study, 41 patients (25 men and 16 women, aged over 15 years) were included, with confirmed acute brucellosis that referred to Brucellosis Research Center in Hamadan, west of Iran between March 2018 to February 2019. At baseline before treatment (first step) and 7 days after gentamicin administration (second step), serum uric acid, blood urea nitrogen (BUN), serum and urine creatinine, erythrocyte sedimentation rate (ESR), quantitative C-reactive protein (CRP) and urinary β2-microglobulin (β2M) were measured. Gentamycin serum level due to the highest risk of nephrotoxicity with this drug in aminoglycoside class was also checked by HPLC method. The data were analyzed using SPSS version 22.

Results: The mean urinary β 2M level, serum and urinary creatinine, uric acid, BUN, and quantitative CRP levels in the first step and second step, there were no statistical differences between the two steps. There was a correlation between urinary creatinine and ESR. In addition, a positive correlation was found between urinary β2M and serum gentamicin level. ESR levels have been significantly reduced in the patients after the treatment compared to before it.

Conclusion: Our findings confirm that gentamicin is safe at the dose of 5 mg/kg/day for one week intravenously in brucellosis patients.

Keywords: Aminoglycoside, β2-microglobulin, brucellosis, nephrotoxicity, patients, aminoglycosides.

[1]
Adetunji SA, Ramirez G, Foster MJ, Arenas-Gamboa AM. A systematic review and meta-analysis of the prevalence of osteoarticular brucellosis. PLoS Negl Trop Dis 2019; 13(1): e0007112.
[http://dx.doi.org/10.1371/journal.pntd.0007112] [PMID: 30657765]
[2]
Golshani M, Buozari S. A review of brucellosis in Iran: Epidemiology, risk factors, diagnosis, control, and prevention. Iran Biomed J 2017; 21(6): 349-59.
[PMID: 28766326]
[3]
Tuon FF, Gondolfo RB, Cerchiari N. Human-to-human transmission of Brucella - a systematic review. Trop Med Int Health 2017; 22(5): 539-46.
[http://dx.doi.org/10.1111/tmi.12856] [PMID: 28196298]
[4]
Majzoobi MM, Hashemi SH, Mamani M, Keramat F, Poorolajal J, Ghasemi Basir HR. Effect of hydroxychloroquine on treatment and recurrence of acute brucellosis: A single-blind, randomized clinical trial. Int J Antimicrob Agents 2018; 51(3): 365-9.
[http://dx.doi.org/10.1016/j.ijantimicag.2017.08.009] [PMID: 28826825]
[5]
Poulikakos P, Falagas ME. Aminoglycoside therapy in infectious diseases. Expert Opin Pharmacother 2013; 14(12): 1585-97.
[http://dx.doi.org/10.1517/14656566.2013.806486] [PMID: 23746121]
[6]
Gentry CA, Rodvold KA, Bertino JS Jr. Methods of minimising the cost of aminoglycoside therapy to hospitals. PharmacoEconomics 1993; 3(3): 228-43.
[http://dx.doi.org/10.2165/00019053-199303030-00006] [PMID: 10146946]
[7]
Ariza J, Bosilkovski M, Cascio A, et al. Perspectives for the treatment of brucellosis in the 21st century: The Ioannina recommendations. PLoS Med 2007; 4(12): e317.
[http://dx.doi.org/10.1371/journal.pmed.0040317] [PMID: 18162038]
[8]
Tuon FF, Cerchiari N, Cequinel JC, et al. Guidelines for the management of human brucellosis in the State of Paraná Brazil. Rev Soc Bras Med Trop 2017; 50(4): 458-64.
[http://dx.doi.org/10.1590/0037-8682-0319-2016] [PMID: 28954065]
[9]
Yousefi-Nooraie R, Mortaz-Hejri S, Mehrani M, Sadeghipour P. Antibiotics for treating human brucellosis. Cochrane Database Syst Rev 2012; 10(10): CD007179.
[PMID: 23076931]
[10]
Hasanjani Roushan MR, Mohraz M, Hajiahmadi M, Ramzani A, Valayati AA. Efficacy of gentamicin plus doxycycline versus streptomycin plus doxycycline in the treatment of brucellosis in humans. Clin Infect Dis 2006; 42(8): 1075-80.
[http://dx.doi.org/10.1086/501359] [PMID: 16575723]
[11]
Skalsky K, Yahav D, Bishara J, Pitlik S, Leibovici L, Paul M. Treatment of human brucellosis: Systematic review and meta-analysis of randomised controlled trials. BMJ 2008; 336(7646): 701-4.
[http://dx.doi.org/10.1136/bmj.39497.500903.25] [PMID: 18321957]
[12]
Keramat F, Ranjbar M, Mamani M, Hashemi SH, Zeraati F. A comparative trial of three therapeutic regimens: Ciprofloxacin-rifampin, ciprofloxacin-doxycycline and doxycycline-rifampin in the treatment of brucellosis. Trop Doct 2009; 39(4): 207-10.
[http://dx.doi.org/10.1258/td.2009.090030] [PMID: 19762571]
[13]
Mahi-Birjand M, Karimzadeh I, Zarban A, Abdollahpour-Alitappeh M, Saadatjoo SA, Ziaee M. Protective effects of silymarin on gentamicin-induced nephrotoxicity in infectious patients: A randomized double blinded placebo-controlled clinical trial. Res Pharm Sci 2020; 26(3): 287-95.
[14]
McWilliam SJ, Antoine DJ, Smyth RL, Pirmohamed M. Aminoglycoside-induced nephrotoxicity in children. Pediatr Nephrol 2017; 32(11): 2015-25.
[http://dx.doi.org/10.1007/s00467-016-3533-z] [PMID: 27848094]
[15]
Shahbazi F, Farvadi F, Dashti-Khavidaki S, Ataei S, Shojaei L. Potential nephroprotective effects of resveratrol in drug induced nephrotoxicity: A narrative review of safety and efficacy data. Adv Tradit Med 2020; 20(4): 529-44.
[http://dx.doi.org/10.1007/s13596-020-00432-y]
[16]
Beitland S, Nakstad ER, Berg JP, et al. Urine β-2-microglobulin, osteopontin, and trefoil factor 3 may early predict acute kidney injury and outcome after cardiac arrest. Crit Care Res Pract 2019; 2019: 4384796.
[http://dx.doi.org/10.1155/2019/4384796] [PMID: 31205786]
[17]
Liu X, Guan Y, Xu S, et al. Early predictors of acute kidney injury: A narrative review. Kidney Blood Press Res 2016; 41(5): 680-700.
[http://dx.doi.org/10.1159/000447937] [PMID: 27676272]
[18]
Taghizadeh-Ghehi M, Sarayani A, Ashouri A, Ataei S, Moslehi A, Hadjibabaie M. Urine neutrophil gelatinase associated lipocalin as an early marker of acute kidney injury in hematopoietic stem cell transplantation patients. Ren Fail 2015; 37(6): 994-8.
[http://dx.doi.org/10.3109/0886022X.2015.1040699] [PMID: 25945602]
[19]
Jou JM, Lewis SM, Briggs C, Lee SH, De La Salle B, McFadden S. ICSH review of the measurement of the erythocyte sedimentation rate. Int J Lab Hematol 2011; 33(2): 125-32.
[http://dx.doi.org/10.1111/j.1751-553X.2011.01302.x] [PMID: 21352508]
[20]
Hashemi SH, Keramat F, Ranjbar M, Mamani M, Farzam A, Jamal-Omidi S. Osteoarticular complications of brucellosis in Hamedan, an endemic area in the west of Iran. Int J Infect Dis 2007; 11(6): 496-500.
[http://dx.doi.org/10.1016/j.ijid.2007.01.008] [PMID: 17344084]
[21]
Zeinalian Dastjerdi M, Fadaei Nobari R, Ramazanpour J. Epidemiological features of human brucellosis in central Iran, 2006-2011. Public Health 2012; 126(12): 1058-62.
[http://dx.doi.org/10.1016/j.puhe.2012.07.001] [PMID: 22884862]
[22]
Ayatollahi J, Dehghanpour Farashah A, Vakili M, Shahcheraghi SH. Frequency of seropositive people for brucellosis in Yazd. Infect Epidemiol Med 2017; 3(1): 16-8.
[http://dx.doi.org/10.18869/modares.iem.3.1.16]
[23]
Lopez-Novoa JM, Quiros Y, Vicente L, Morales AI, Lopez-Hernandez FJ. New insights into the mechanism of aminoglycoside nephrotoxicity: An integrative point of view. Kidney Int 2011; 79(1): 33-45.
[http://dx.doi.org/10.1038/ki.2010.337] [PMID: 20861826]
[24]
Pandya D, Nagrajappa AK, Ravi KS. Assessment and correlation of urea and creatinine levels in saliva and serum of patients with chronic kidney disease, diabetes and hypertension–a research study. J Clin Diagn Res 2016; 10(10): ZC58-62.
[http://dx.doi.org/10.7860/JCDR/2016/20294.8651] [PMID: 27891460]
[25]
Weiner ID, Mitch WE, Sands JM. Urea and ammonia metabolism and the control of renal nitrogen excretion. Clin J Am Soc Nephrol 2015; 10(8): 1444-58.
[http://dx.doi.org/10.2215/CJN.10311013] [PMID: 25078422]
[26]
Seki M, Nakayama M, Sakoh T, et al. Blood urea nitrogen is independently associated with renal outcomes in Japanese patients with stage 3-5 chronic kidney disease: A prospective observational study. BMC Nephrol 2019; 20(1): 115.
[http://dx.doi.org/10.1186/s12882-019-1306-1] [PMID: 30940101]
[27]
Lai JH, Luo SF, Hung LF, et al. Physiological concentrations of soluble uric acid are chondroprotective and anti-inflammatory. Sci Rep 2017; 7(1): 2359.
[http://dx.doi.org/10.1038/s41598-017-02640-0] [PMID: 28539647]
[28]
Solera J, Espinosa A. Martínez-Alfaro E, et al. Treatment of human brucellosis with doxycycline and gentamicin. Antimicrob Agents Chemother 1997; 41(1): 80-4.
[http://dx.doi.org/10.1128/AAC.41.1.80] [PMID: 8980759]
[29]
Braga MC, Fonseca FLA, Marins MM, et al. Evaluation of beta 2-microglobulin, cystatin C, and lipocalin-2 as renal biomarkers for patients with fabry disease. Nephron 2019; 143(4): 217-27.
[http://dx.doi.org/10.1159/000500570] [PMID: 31216546]
[30]
Branten AJ, du Buf-Vereijken PW, Klasen IS, et al. Urinary excretion of beta2-microglobulin and IgG predict prognosis in idiopathic membranous nephropathy: A validation study. J Am Soc Nephrol 2005; 16(1): 169-74.
[http://dx.doi.org/10.1681/ASN.2004040287] [PMID: 15563570]
[31]
Schardijn GH, Statius van Eps LW. Beta 2-microglobulin: Its significance in the evaluation of renal function. Kidney Int 1987; 32(5): 635-41.
[http://dx.doi.org/10.1038/ki.1987.255] [PMID: 3323598]
[32]
Uchino H, Fujishima J, Fukuoka K, et al. Usefulness of urinary biomarkers for nephrotoxicity in cynomolgus monkeys treated with gentamicin, cisplatin, and puromycin aminonucleoside. J Toxicol Sci 2017; 42(5): 629-40.
[http://dx.doi.org/10.2131/jts.42.629] [PMID: 28904298]
[33]
Gibey R, Dupond JL, Alber D, Leconte des Floris R, Henry JC. Predictive value of urinary N-acetyl-beta-D-glucosaminidase (NAG), alanine-aminopeptidase (AAP) and beta-2-microglobulin (beta 2M) in evaluating nephrotoxicity of gentamicin. Clin Chim Acta 1981; 116(1): 25-34.
[http://dx.doi.org/10.1016/0009-8981(81)90165-0] [PMID: 6172216]
[34]
Fanni F, Shahbaznejad L, Pourakbari B, Mahmoudi S, Mamishi S. Clinical manifestations, laboratory findings, and therapeutic regimen in hospitalized children with brucellosis in an Iranian Referral Children Medical Centre. J Health Popul Nutr 2013; 31(2): 218-22.
[http://dx.doi.org/10.3329/jhpn.v31i2.16386] [PMID: 23930340]
[35]
Osei-Bimpong A, Meek JH, Lewis SM. ESR or CRP? A comparison of their clinical utility. Hematology 2007; 12(4): 353-7.
[http://dx.doi.org/10.1080/10245330701340734] [PMID: 17654065]

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