Nephrotoxicity of cefepime: A new cephalosporin antibiotic in rats

Abstract

Objectives:To investigate the nephrotoxic effect and biochemical alterations induced by cefepime in rats.Materials and Methods:Cefepime was administered intramuscularly at doses of 45, 90 and 180 mg/kg b.wt. once daily for 5 consecutive days. The serum and urine samples were used for quantitative determination of urea, creatinine, glucose, total protein, calcium, sodium and potassium. The histopathological examination of kidney tissues was performed 1, 4 and 8 days after the last dose of cefepime administration.Results:Cefepime induced a significant increase in the total amount of urine per day, urea and creatinine concentration in the serum and urine and significant decrease in their clearance. Cefepime also caused a significant gluocosuria and proteinuria and significant decrease in their serum concentrations. The effect of cefepime on serum and urine concentrations of calcium, sodium and potassium were also determined. Cefepime injection in the three tested doses caused renal tubular, glomerular and vascular changes. The severity of these changes was dose dependent. In conclusion, these results suggest a possible contribution of cefepime in the nephrotoxicity and biochemical alterations, especially at high doses. Therefore, the renal functions should be monitored during the cefepime therapy.

A Study on the Toxic Effect of Different Doses of Diclofenac Sodium on the Development of the Kidney in the Postnatal Period

“…The current findings suggested that proximal convoluted tubules were the frequently affected renal tubular cells, that attributed to cellular metabolic pathways are greatly vulnerable to nephrotoxic agents as DS (Elsayed et al, 2014). And this is supported by others observation (Sabry et al).…”

Comparative Incidence of Acute Kidney Injury in Critically Ill Patients Receiving Vancomycin with Concomitant Piperacillin‐Tazobactam or Cefepime: A Retrospective Cohort Study

“…Semisynthetic penicillins, including piperacillin‐tazobactam, likely cause AKI through an acute interstitial nephritis (AIN)‐mediated mechanism that was described in numerous case reports . A single case report and pharmacokinetic studies in rats have demonstrated that cefepime may cause AKI due to an AIN‐mediated mechanism as well; however, further evaluation into this potential mechanism is needed . The exact mechanism behind AKI due to β‐lactams and vancomycin is unknown; however, an additive effect of AIN and direct cellular necrosis may be responsible …”

“…9-14, 53, 54 A single case report and pharmacokinetic studies in rats have demonstrated that cefepime may cause AKI due to an AIN-mediated mechanism as well; however, further evaluation into this potential mechanism is needed. 55,56 The exact mechanism behind AKI due to b-lactams and vancomycin is unknown; however, an additive effect of AIN and direct cellular necrosis may be responsible. 4,10,11,13,14 To our knowledge, this is the first evaluation of an entirely critical care population for the effects of vancomycin and concomitant piperacillin-tazobactam or cefepime on AKI development.…”

Nephroprotective Effect of Pterocarpus indicus Willd. Leaves : Observation of Urine Volume, Sodium and Potassium Levels in Gentamicin-induced Rat Model

“…Those substances appear in the urine if plasma level exceeds or when renal tubules defects, possibly resulting in nephrotoxicity. 20 Thus, urine sodium and potassium levels can predict its correlation as demonstrated in the present study. Measurements for 24-h urinary sodium in group V presented low concentration of urinary sodium.…”