RELATIONSHIP BETWEEN HYDRATION STATUS AND RENAL FUNCTION IN PATIENTS RECEIVING AMINOGLYCOSIDE ANTIBIOTICS.
Contributors: University of Alabama at Birmingham.
Published: 1993
Number of pages: 82
Subjects: Health Sciences, Nursing.
Description: The purpose of this study was to investigate the relationship between hydration status and renal function in patients receiving aminoglycoside antibiotics. Data were obtained by chart review. Hydration status was measured by central venous pressure (CVP) readings, differences in patients' intakes and outputs, and patients' weight gains. Renal function was determined by calculating changes in serum creatinine levels. Numerous risk factors and type of nursing unit on which the patient was placed were used as covariates. The sample consisted of 126 adult patients receiving gentamicin, tobramycin, or amikacin.

CVP readings showed a positive but not statistically significant correlation with renal function (r =.39, p =.103) but were infrequently documented. Differences in intake and output and weight gain did not appear to be related to protection of renal function $(r = -.0195,\ p = .415;$ r =.148, p =.061, respectively). Of the various risk factors examined, only vancomycin had a significant correlation with renal function (r = $-$.661, p =.026). Patients taking aminoglycoside antibiotics and located in the SICU were less likely to have impairment of renal function (r =.178, p =.023) than those patients located in the MICU $(r = -.147,\ p = .056).$ Hydration, as measured by weight gain, appeared to have a small protective effect for renal function if receiving dopamine, cephalosporin antibiotics, and vancomycin and were considered as covariates (R$\sp2$ =.056, p =.0498). When subjects were limited to those with normal antibiotic peak and trough levels, the protective effect of hydration, as measured by weight gain, was even greater. It is important that nurses be alert to the possibility of impairment of renal function in their patients and the fact that optimal hydration may be protective.

Recommendations based on the results of this study include replication using subjects with frequently recorded pulmonary wedge pressure and CVP readings, replication using subjects with documented normal serum peak and trough levels, and replication using weight gain as the indicator of hydration and selected risk factors for renal impairment as covariates. The Neuman Systems Model of Nursing was useful in explaining the relationships studied and should continue to be utilized in nursing practice.
Notes: Source: Dissertation Abstracts International, Volume: 55-02, Section: B, page: 0365.

Thesis (D.S.N.)--UNIVERSITY OF ALABAMA AT BIRMINGHAM, 1993.

School code: 0005.