Renal Wasting of Electrolytes: Effect of Amikacin Used to Treat Infections - Tip of Iceberg for the Physicians

Abstract

Objective: To measure prospectively the effect of treatment with the Amikacin on renal magnesium, potassium and phosphate wasting in patients with extrarenal infections.

Study Design: Case series.

Place and Duration of Study: Department of Nephrology, Pak Emirates Military Hospital, Rawalpindi Pakistan from Jul to
Dec 2019.

Methodology: A total of 40 cases were included in this study in liaison with other departments who were put on Amikacin
standard dose. Urinary electrolytes including potassium, magnesium and phosphate were measured at day 4 after the use of Amikacin. Factors like age, gender, cause for which Amikacin was used, day 1 creatinine and day 4 creatinine were correlated with presence of electrolyte wasting in the target population.

Results: Mean age of study participants was 39.1±12.56 years. 25(62.5%) were males while 15(37.5%) were females.
Commonest cause for the use of Amikacin was drug resistant tuberculosis followed by fractures. Mean urinary magnesium
was 39.1±12.56 mmol/24 hours, while potassium was 26.1±15.60 meq/24 hours. Mean phosphate was 66.4±53.55 mg/24
hours. Pearson chi-square test revealed that advanced age and day 4 creatinine were strongly linked with the presence of
urinary electrolyte wasting among the patients receiving Amikacin for extra-renal infections with p-value<0.05.

Conclusion: Electrolyte wasting emerged as a common finding in the patients put on Amikacin suffering from extra renal
infections. Patients with advancing age put on Amikacin should be given special attention and screened for electrolyte
wasting at priority. ..