Physiologic changes of serum creatinine level following aminoglycoside exposure in neonatal sepsis

Abstract

BACKGROUND: The study aimed to assess the pattern of serum creatinine levels changes and prevalence of AKI after aminoglycoside treatment for seven days in neonatal sepsis.METHODS: This prospective cohort study included preterm and full-term newborns admitted with suspected sepsis and received aminoglycosides. SCr levels were measured before and after aminoglycoside treatment for seven days using the Jaffe method, and the results were compared between the two groups of newborns. AKI was determined according to the kidney disease: Improving Global Outcome (KDIGO) criteria.RESULTS: A total of 37 preterm and 35 full-term newborns were included in the study. SCr levels before and after aminoglycoside treatment for seven days, were 0.78 vs. 0.57 mg/dL (P=0.008) in preterm, and 0.60 vs. 0.44 mg/dL (P=0.124) in full-term newborns. In both groups, SCr levels decreased despite treatment with an aminoglycoside, but only in preterm, the decrease was significant. After aminoglycoside treatment, there was no significant difference in SCr levels between the two groups. The prevalence of AKI in preterm and full-term newborns was 18.9% vs. 15.3% (P=0.598). There was no significant correlation between AKI and gestational age, chronological age, birth weight, type of aminoglycoside, and urine output.CONCLUSIONS: SCr level changes after aminoglycoside treatment appear to follow a pattern of physiological decline and have not been affected by gestational age. AKI occurrence is a sign that aminoglycoside should be administered with caution, especially in newborns with high-risk underlying diseases.

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