What are the risk factors for aminoglycoside caused acute tubular necrosis (ATN)?

Updated: Mar 15, 2021
  • Author: Sangeeta Mutnuri, MBBS; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Aminoglycoside-related toxicity occurs in 10-30% of patients receiving aminoglycosides, even when blood levels are in apparently therapeutic ranges. Risk factors for ATN in these patients include the following:

  • Preexisting liver or kidney disease
  • Concomitant use of other nephrotoxins (eg, amphotericin B, radiocontrast media, cisplatin)
  • Shock
  • Advanced age
  • Female sex
  • Higher aminoglycoside level 1 hour after dose (a high trough level has not been shown to be an independent risk factor)

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