克林霉素膦酸酯致急性肾衰竭临床分析

Clinical Analysis of Acute Renal Failure Due to Clindamycin Phosphonate

目的 探讨克林霉素膦酸酯所致急性肾衰竭的临床特点及预后。方法 分析近3年来我院收治的18例应用克林霉素膦酸酯后发生急性肾衰竭患者的临床资料，总结克林霉素膦酸酯所致急性肾衰竭的临床特点、治疗及预后。结果 18例患者中15例静脉滴注克林霉素膦酸酯结束后即出现肉眼全程血尿1—2次，5例患者出现少尿；18例患者尿液检查为血尿、蛋白尿及尿液N-乙酰-B—D-氨基葡萄糖苷酶（NAG）明显增高，肾小球滤过功能明显减退。经停用克林霉素膦酸酯，给予地塞米松静脉注射，维持水、电解质平衡治疗，其中5例少尿患者行短期血液透析治疗，患者肾功能均恢复正常。结论 克林霉素膦酸酯可导致肾损伤，引起血尿、蛋白尿、急性肾衰竭，应注意合理使用，防治不良反应。

Objective To investigate the clinical features and prognosis of acute renal failure （ARF） due to clindamycin phosphonate （CP）. Methods Clinical characteristics, therapy and prognosis of 18 ARF patients due to CP use in our hospital over the past 3 years were analyzed. Results Fifteen of all patients presented a symptom of gross total hematuria （ 1 - 2 times） after CP intravenous drips, 5 presented a oliguresis symptom. Hematuria, proteinuria and N - acetyl - 13 - D - glucosaminidase （NAG） in urine increased significantly, and glomerular filtration function decreased significantly in all. After stopping use of clindamycin, they were given dexarnethasone intravenous injection and treatment of maintaining water and electrolyte balance, 5 oliguric patients underwent short - term hemodialysis treatment. Renal function of all patients returned to normal. Conclusion Clindamycin can lead to kidney damage, causing hematuria, proteinuria and acute renal failure. Rational use of it should be made, to control adverse reactions.