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  • Author: Biljana Davidović-Plavšić x
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Biljana Davidović-Plavšić, Tatjana Vujić, Snežana Uletilović, Jelica Predojević-Samardžić, Dragana Malčić and Živko Saničanin

Urinary Activities of Proximal Tubule Enzymes in Neonates Treated with Gentamicin

In order to determine the nephrotoxicity of gentamicin, an aminoglycoside antibiotic, activity of the enzymes dominantly localized in proximal tubules, i.e. alanine aminopeptidase (AAP), γ-glutamyl transferase (GGT) and N-acetylβ-D-glucosaminidase (NAG) was examined. Determinations were performed in 12-h urine samples of 30 neonates i.v. receiving gentamicin against Gram negative infections in daily doses of 5.0 mg/kg body mass for 10 consecutive days. The activities of the same enzymes were measured in 12-h urine samples of 30 examinées of the control group. The groups consisted of neonates of both sexes. The pretreatment period lasted for 5 days. On day 8 of gentamicin application, statistically significant differences in the activity of AAP and GGT expressed in U/mmol creatinine between the gentamicin-receiving and control group (p<0.01) were found. No significant differences in NAG activity of the gentamicin-treated group in comparison with the control were recorded during the 10-day gentamicin therapy. It can be concluded that 10-day treatment of neonates with usually prescribed gentamicin doses results in mild nephrotoxic changes close to the end of the therapy accompanied by increased activity of both urinary AAP and GGT, known as very sensitive indicators of nephrotoxicity. During the same treatment period no changes in NAG activity were observed, meaning that the antibiotic causes no severe injuries to proximal tubule cells at the level of cellular organelles.

Open access

Tatjana Vujić, Snežana Uletilović, Jelica Predojević-Samardžić, Biljana Davidović-Plavšić, Svjetlana Stoisavljević-Šatara and Živko Saničanin

The Activity of Proximal Tubule Enzymes in the Urine of Cephalexin-Treated Patients

The activities of alanine aminopeptidase (AAP), γ-glutamyltransferase (GGT) and N-acetyl-β-D-glucosaminidase (NAG), enzymes dominantly localised in the epithelial proximal tubule cells, were measured with an aim of determining the nephrotoxicity of a cephalosporin antibiotic cephalexin. Enzymatic activities were measured in the 12-h urine samples of patients receiving cephalexin orally for 15 days in daily doses of 50 mg/kg body mass against Gram-positive infections of the respiratory or urinary tract. The same enzymes were determined in the 12-h urine samples of the corresponding control. Both the control and the experimental group consisted of 30 examinees of both sexes, age range 3-10 years. Statistically significant differences in AAP and GGT activities expressed as U/mmol creatinine were recorded after 12 days of cephalexin therapy in comparison with the control (p < 0.01). At the same time, no significant differences in NAG activity of the patients in relation to the control were observed during the entire course of the therapy. Based on the obtained results it can be concluded that treatment of 3-10 years old patients with the applied cephalexin doses for 15 days results in mild nephrotoxic changes close to the end of therapy accompanied by increased activities of AAP and GGT, the enzymes known as very sensitive indicators of nephrotoxicity. The results showing that during the entire period of cephalexin application no changes in NAG, as a lysosomal enzyme, were observed, could be taken as a proof that this antibiotic did not lead to severe injuries of epithelial proximal tubule cells at the level of cell organelles.