8th World Nephrology Conference
Sao Paulo, Brazil
Title: Non-pharmacological approaches for managing gentamicin nephrotoxicity
Biography: Elisa Mieko Suemitsu Higa
Introduction: Gentamicin (G) is an antibiotic largely used to treat Gram negative infections; however, its main side effect is the acute tubular necrosis. It was previously observed, both in experimental models in our Laboratory, as in the clinical settings by others, that after suspension of gentamicin, renal function apparently recovers to normal, based on plasma urea and creatinine clearance. However, when the animals or the patients are challenged with the same antibiotic again, or with other nephrotoxins, the reduction of renal function is maximized. Physical activity has been used as an adjuvant tool to prevent many diseases such as hypertension and diabetes. The aim of this study was to evaluate the effects of aerobic exercises on the recovery phase of G induced acute kidney injury (AKI) in rats. Methods: Male adult Wistar rats were allocated into 4 groups: W10+R30, G10+R30, W10+EX30 and G10+EX30; in which W10 received water (G vehicle) and G10 received G for 10 days; R30 remained resting and EX30 made exercise. Moderate training was performed on treadmill during 30 days. Pre and post training, blood and 24hr urine were collected for creatinine, urea, proteinuria, nitric oxide (NO), TBARS (thiobarbituric acid reactive substances, an indirect measurement of lipid peroxidation), ROS (reactive oxygen species) and antioxidant analysis. Post training, kidneys were removed for ROS, antioxidant and histological analysis. Results: After 10 days of G treatment, renal function was decreased, but it was recovered by R30 or EX30; NO synthesis was increased in the plasma and urine, and decreased in the kidney of G10+R30 and G10-EX30 groups. In G10+EX30 vs G10+R30 plasma, urinary and renal TBARS were reduced; catalase, glutathione and superoxide dismutase were increased. Histological analysis showed no difference between these groups. Conclusions: We believe that the aerobic training, through its effect on oxidative stress and on the antioxidant defense, can protect against further functional deterioration that could occur to the kidneys, and/or protect this organ against new insults. Keywords: nephrotoxicity, gentamicin, nitric oxide, acute kidney injury, oxidative stress and antioxidants.