A HISTOLOGICAL STUDY OF THE EFFECT OF AMIKACIN ON THE KIDNEY OF ALBINO RAT AND THE POSSIBLE PROTECTIVE ROLE OF ANTIOXIDANTS
Hafez Waly, Mohamed Bakry, Tarek Abdel Moneim and Ahmed Galal
Department of Anatomy, Faculty of Medicine, Cairo University
Amikacin is an aminoglycosides antibiotic which has been widely used in the treatment of gram-negative infections. The therapeutic dose of amikacin is 15 mg/kg body weight daily for 10 days. Nephrotoxicity has been recognized as a major complication of aminoglycoside antibiotics for many years. The aim of this work was to study the nephrotoxic effect of administration of different doses of amikacin at different durations and to study the possible protective role of antox which is a mixture of different antioxidants (vitamin C, vitamin A, vitamin E, selenium and medicinal yeast) in one available tablet. Forty-eight adult male albino rats with an average weight of 250 grams were used in this work. They were divided into 4 groups. Group I (Sham control), eight rats, injected with 1 ml isotonic saline. Group II, eight rats, received the therapeutic dose of amikacin for 10 days. Group III injected with the therapeutic dose of amikacin for 20 days (IIIA, 8 rats), and another 8 rats received in addition to this regimen, 0.1 ml antox for 20 days (Group IIIB). In group IV, eight rats received double the therapeutic dose of amikacin for 10 days (IVA), the other eight rats received antox plus double the therapeutic dose of amikacin for 10 days (IVB). Histological examination of renal sections of group I and group II showed normal structure of the glomeruli and the convoluted tubules with intact basement membranes. On the other hand, examination of renal sections of group IIIA and IVA revealed congestion of the glomeruli with marked thickening of the periglomerular connective tissue. There was degeneration of the convoluted tubules in the form of cloudy swelling, together with extravasation of blood in between. From the findings of the present work, it could be stated that amikacin seems to be a safe drug when administered in the therapeutic dose and duration as seen in group II. On the other hand, amikacin is a nephrotoxic drug if taken for longer duration, i.e. 20 days as seen in group IIIA or in high dose i.e. 30 mg/kg/day as seen in group IVA. Histological examination of the renal sections of group IIIB and IVB showed normal glomerular structure with mild degeneration of some convoluted tubules. In the present work it was evident that the use of antox prevents the glomerular congestion and periglomerular connective tissue fibrosis, minimizes the degeneration of the convoluted and collecting tubules and diminishes the peritubular connective tissue fibrosis. The present work proved the protective role of antox against the degenerative changes induced by amikacin in the kidney, so we advise the use of antox in combination with amikacin to protect the kidney from this toxicity. The nephrotoxic reaction with amikacin can be avoided when the therapeutic dose is not exceeded, the duration is not prolonged, the patients are well hydrated, the kidney function is normal and antox is used as protective therapy.