PHARMACOKINETICS OF GENTAMICIN IN PATIENTS WITH VARIOUS LEVELS OF DIABETIC PROTEINURIA

Diabetic nephropathy is a relatively common medical problem. The effec ts of early-stage nephropathy on the kinetic disposition of renally cl eared drugs have received little attention. This study evaluated singl e-dose pharmacokinetics of gentamicin in 15 patients with various leve ls of diabetic proteinuria who had relatively normal serum creatinine concentrations. These pharmacokinetic parameters were compared with pr edicted parameters based on the method used clinically in our institut ion. The correlation between the amount of proteinuria and each of the pharmacokinetic parameters was also evaluated. The patients evaluated in this series had a gentamicin volume of distribution (P < 0.05) and half-life (P < 0.05) significantly higher than predicted and a gentam icin clearance (P < 0.01) significantly lower than predicted. A signif icant correlation between the amount of proteinuria and the measured p harmacokinetic parameters was not observed. These findings suggest tha t patients with diabetic proteinuria should be monitored closely when treated with aminoglycosides.