AMINOGLYCOSIDE NEPHROTOXICITY FOLLOWING SINGLE-DOSE CYSTOSCOPY PROPHYLAXIS

OBJECTIVE: To report a case of gentamicin-associated acute tubular nec rosis following single-dose exposure. SETTING: Central-city, universit y-affiliated teaching hospital. PATIENT: An 82-year-old man, admitted for evaluation of shortness of breath, appetite reduction with weight loss, and stable renal insufficiency, developed urinary retention, whi ch prompted a urologic evaluation followed by a cystoscopy. INTERVENTI ONS: A single 1.6-mg/kg (actual body weight) dose of gentamicin was ad ministered as prophylaxis prior to this procedure. RESULTS: A signific ant decline in renal function was observed 48 hours following gentamic in administration. A nephrology evaluation excluded pre- and postrenal causes and attributed this episode of nonoliguric acute tubular necro sis to a single dose of gentamicin. CONCLUSIONS: Although not consiste nt with currently proposed mechanisms and reported onset of aminoglyco side-induced nephrotoxicity, an etiology other than that concluded by this case report appears unlikely.