Positive Correlation Between Kidney Injury Molecule-1 and Gentamicin Trough Level in Neonates with Infection
Background: Gentamicin is a nephrotoxic drug but chosen for neonates with severe infection. Early detection of kidney injury regarding the use of gentamicin is highly needed. Kidney Injury Molecule-1 (KIM-1) is one of the new specific and sensitive biomarker for kidney damage.
This study aimed to determine the association between urinary KIM-1 and the trough level of gentamicin in neonates with infection. Method: This observational study is conducted on neonates with infection hospitalized in Perinatology Unit Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Blood samples were taken from the heel pricks for 1 to 3 doses just before gentamicin administration (trough level). Gentamicin plasma concentrations were measured by Liquid Chromatography Tandem Mass Spectrometry while urinary KIM-1 levels were measured using enzyme-linked immunosorbent assay.
Results: Twenty-seven neonates treated with gentamicin were included in the study and measured for 34 trough gentamicin levels. There were 18 gentamicin trough levels higher than the safe concentrations (2 mcg/mL). Normalized KIM-1 to creatinine levels in patients with high gentamicin
trough concentration was significantly different from those who had safe trough levels (p = 0.015). The mean difference for normalized KIM-1 levels between those two groups was 3.85±1.409 mcg/g creatinine (95% CI: 0.845 to 6.85). There was a moderate correlation between gentamicin
trough levels and log normalized KIM-1 level (p = 0.007; r = 0.63; r2 = 0.39). Conclusion: Kidney Injury Molecule-1 urinary levels could be an early signal for gentamicin dose adjustment before kidney injury occurs in neonates.
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Kidney Injury Molecule-1;
Document Type: Research Article
Department of Medical Pharmacy, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia
Department of Pharmacology and Therapeutics, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia
Neonatology Division, Cipto Mangunkusumo General Hospital, Jakarta, 10430, Indonesia
Provincial Health Laboratory, Ministry of Health, Jakarta, 10430, Indonesia
Publication date: April 1, 2017
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