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Carbenicillin Concentrations in Normal and Diseased Kidneys
A Therapeutic Consideration
- ANDREW WHELTON, M.D.;
- GORDON G. CARTER, A.B.;
- HENRY H. BRYANT, M.S.;
- L. ARLENE PORTEOUS, B.S.; and
- W. GORDON WALKER, M.D., F.A.C.P.
Abstract
Renal tissue concentrations of carbenicillin and its intrarenal distribution are markedly influenced by alterations in the physiologic activity of the normal kidney or by the presence of severe disease in the renal parenchyma. In the hydropenic state, cortical, papillary, and urinary levels may be as much as 3, 17½, or 535 times greater, respectively, than the concomitant serum level. Hydration abolishes this increased cortico-papillary-urinary gradient pattern. Severe disease in human kidneys markedly decreases the renal parenchymal penetration of carbenicillin and significantly reduces the urine concentrations. This decreased renal tissue concentration averages 4 to 14 times less than the concentration in normal renal tissue. These changes in the renal and urinary pharmacokinetics of carbenicillin, in health and disease, have not been previously defined; they must be taken into account in the therapy of pyelonephritis and urinary tract infections.
Article and Author Information
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▸From the O'Neill Research Laboratories of the Department of Medicine, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland; and The National Center for Antibiotic Analysis, Food and Drug Administration, Department of Health, Education, and Welfare, Washington, D.C.
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Supported by grants AM-11870, 5 T01 AM05655-02, and grant RR35 for a General Clinical Research Center, from U.S. Public Health Service, Washington, D.C.
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▸Requests for reprints should be addressed to Andrew Whelton, M.D., Renal Division, The Johns Hopkins Hospital, Baltimore, Md. 21205.
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- Received October 30, 1972.
- Accepted January 19, 1973.
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