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Nephrol Dial Transplant (2000) 15: 822-826
© 2000 European Renal Association-European Dialysis and Transplant Association

Aminoglycosides and renal magnesium homeostasis in humans

Rodo O. von Vigier1, Anita C. Truttmann1, Karin Zindler-Schmocker1, Alberto Bettinelli1,, Carmen Casaulta Aebischer1, Bendicht Wermuth2 and Mario G. Bianchetti1,

1 Department of Pediatrics and 2 Department of Clinical Chemistry, University of Bern, Bern, Switzerland

Background. The use of aminoglycosides has been linked with hypomagnesaemia in scattered reports. The objective of the study was to measure prospectively the effect of treatment with the aminoglycoside amikacin on renal magnesium homeostasis.

Methods. Twenty-four cystic fibrosis patients (aged 9–19 years) admitted because of exacerbation of pulmonary symptoms caused by Pseudomonas aeruginosa were treated with the aminoglycoside amikacin and the cephalosporin ceftazidime for 14 days. Renal values and plasma and urinary electrolytes were measured before and at the end of the systemic anti-pseudomonal therapy.

Results. In the patients with cystic fibrosis, treatment with amikacin and ceftazidime did not modify plasma creatinine or urea and plasma or urinary sodium, potassium and calcium. Treatment with amikacin and ceftazidime significantly decreased both plasma total magnesium (from 0.77 (0.74–0.81) to 0.73 (0.71–75) mmol/l; median and interquartile range) and ionized magnesium (from 0.53 (0.50–0.55) to 0.50 (0.47–0.52) mmol/l) concentration and increased fractional urinary magnesium excretion (from 0.0568 (0.0494–0.0716) to 0.0721 (0.0630–0.111)) and total urinary magnesium excretion (from 30.7 (26.5–38.0) to 38.5 (31.5–49.0) µmol/l glomerular filtration rate).

Conclusions. The present study demonstrates that systemic therapy with amikacin plus ceftazidime causes mild hypomagnesaemia secondary to renal magnesium wasting even in the absence of a significant rise in circulating creatinine and urea.

Keywords: aminoglycosides; cystic fibrosis; kidney disease; magnesium; magnesium deficiency

Correspondence and offprint requests to: Dr M. G. Bianchetti, Inselspital, CH-3010 Bern, Switzerland.

Present address: Second Department of Pediatrics, University of Milan, Italy.


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