Antimicrobial Prophylaxis in Kidney Disease

Abstract

Acute bacterial pyelonephritis produces little abnormality of renal function, but the histologic lesion of chronic pyelonephritis is often found in azotemic patients. Most evidence suggests that infection plays little role in producing this renal insufficiency. On the other hand, infectious complications of urethral catheterization are undisputed and often avoidable. Immunologic sequelae of infection at distant sites can produce glomerular iniury, but again prophylaxis offers little benefit. Knowledge of the pharmacology of nephrotoxic antibiotics is necessary to protect renal function.