Renal Disease and the Metabolic Effects of Tetracycline

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Abstract
With obvious kidney impairment, tetracycline may cause clinical and biochemical changes in proportion to degree of renal insufficiency and dosage and duration of treatment. Effects include increasing azotemia, hyperphosphatemia, acidosis, anorexia, nausea and vomiting, weight loss and increased urinary losses of N and Na. In those with advanced renal disease, peak effect may not manifest itself for as long as 6 days after discontinuation. These changes are reversible but symptomatology and morbidity may be considerable. Anabolic steroids may prevent or retard many symptomatic and chemical manifestations. Tetracycline should be given in reduced dosage with proper precautions in cases of significant kidney impairment. While individuals with adequate kidney function may excrete more N and Na, significant blood chemistry or clinical changes do not develop. Effect on N metabolism is of systemic origin, and it is suggested that tetracycline exerts an antianabolic action by inhibiting amino acid incorporation into protein.