Hypermagnesiuria and hypercalciuria in childhood leukemia: An effect of amikacin therapy

被引:12
作者
Wu, B
Atkinson, SA
Halton, JM
Barr, RD
机构
[1] CHILDRENS HOSP CHEDOKE MCMASTER,HAMILTON,ON L8N 3Z5,CANADA
[2] MCMASTER UNIV,HAMILTON,ON L8N 3Z5,CANADA
关键词
leukemia; children; magnesium; calcium; aminoglycoside; renal toxicity;
D O I
10.1097/00043426-199602000-00017
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: The purpose of this study is to assess the effects of amikacin on renal proximal tubular function, and on magnesium (Mg) and calcium (Ca) status in children treated for acute lymphoblastic leukemia (ALL). Patients and Methods: Eighteen children (11 male/7 female, ages 2-18 years) receiving antileukemic therapy (Dana Farber Cancer Institute protocols 87-001 or 91-001) and admitted for febrile neutropenia to The Children's Hospital at Chedoke-McMaster, Hamilton, Ontario were recruited into this descriptive prospective study. Each child was treated with amikacin (7.5 mg/kg/12 h x 10-14 days) for one or more courses. Results: No patient demonstrated elevations in amikacin trough levels. beta(2)-Microglobulinuria, glucosuria, proteinuria, and hyperphosphaturia were absent. Children (50%) presenting with hypomagnesemia (<0.77 mmol/L) had a significant rise in mean urinary Mg:creatinine (0.46 +/- 0.27 versus 0.82 +/- 0.38 mmol, mean +/- SD, p < 0.05) in response to amikacin therapy and the mean Ca:creatinine ratio increased by 95% after 10-14 days of amikacin treatment. Serum Mg and Ca did not change notably after treatment, irrespective of initial Mg status. Conclusions: Aminoglycoside therapy in children with ALL is not associated with overt nephrotoxicity. A transient renal leak of Mg and Ca does occur. Screening of ALL children for mild hypomagnesemia may help to identify those most at risk of disruption of renal conservation of Mg and possibly Ca.
引用
收藏
页码:86 / 89
页数:4
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