Amikacin에 의한 신독성에 미치는 간질환의 영향

Abstract

Liver disease predisposes to aminoglycoside nephrotoxicity but specific features of such disease that may predispose to amikacin-induced renal injury have not been identified. The objective of this study was to identify risk factors associated with amikacin-induced renal injury. A retrospective chart review of 90 patients who had received more than three doses of amikacin between December 2005 and August 2006 was conducted; 35 patients with liver disease and 55 controls were included. Patients with liver disease showed more nephrotoxicity than control based on the creatinine level changes. (0.05 ± 0.09 mg/dL vs 0.51 ± 0.72 mg/dL, p < 0.05). The initial pre-treatment serum albumin level was lower in patients who developed amikacin-induced nephrotoxicity(3.19 ± 0.72 g/dL vs 2.77 ± 0.61 g/dL, p < 0.05). The pre-treatment albumin level correlated with the change in creatinine level during amikacin therapy(p < 0.05). Based on the results, it was concluded that amikacin should be avoided in liver disease patients with low serum albumin level.