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The risk of serious side-effects such as nephrotoxicity is the principal limitation of gentamicin (GEN) therapeutic efficacy. Oxidative stress is considered to be an important mediator of GEN- induced nephrotoxicity. The present study was designed to evaluate the efficacy of the combination of melatonin (MT) plus atorvastatin (ATO) against GEN-induced nephrotoxicity in rats. We utilized 30 male Wistar albino rats allocated in 5 groups, each containing 6 rats: control, GEN (100 mg/kg/day), ATO (10 mg/kg/day) + GEN, MT (20 mg/kg/day) + GEN, and ATO (10 mg/kg/day) plus MT (20 mg/kg/day) + GEN. Kidney weight, serum creatinine and urea concentration, renal ROS, MDA, GSH levels, SOD, and CAT activity were determined. GEN-induced nephrotoxicity was evidenced by marked elevations in serum urea and creatinine, kidney weight, renal ROS, and MDA levels and reduction in renal GSH level, SOD and CAT activity. MT pretreatment significantly lowered the elevated serum creatinine concentration, kidney weight, renal ROS and MDA levels. However ATO could not reduce these parameters, but similarly to MT, it was able to enhance the renal GSH level, CAT and SOD activity. In addition, a combination therapy of MT plus ATO enhanced the beneficial effects of ATO, while not changing the effects of MT effects or even improving them. The present study indicates that a combination therapy of MT plus ATO can attenuate renal injury in rats treated with GEN, possibly by reducing oxidative stress, and it seems that MT can enhance the beneficial effects of ATO. Key words: melatonin, atorvastatin, gentamicin, nephrotoxicity, oxidative stress, rats. Le risque de presenter de graves effets indesirables de nephrotoxicite est la principale limite de l'efficacite therapeutique de la gentamicine (GEN). En fait, on considere que le stress oxydatif pourrait etre un important intermediaire de la nephrotoxicite induite par la GEN. La presente etude a ete concue en vue d'evaluer l'efficacite de l'association de la melatonine (MT) avec l'atorvastatine (ATO) contre la nephrotoxicite induite par la GEN chez le rat. A cet effet, nous avons utilise 30 rats Wistar albinos males repartis dans 5 groupes de 6 rats : temoin, GEN (a 100 mg/kg/jour), ATO (a 10 mg/kg/jour) + GEN, MT (a 20 mg/kg/jour) + GEN et ATO (a 10 mg/kg/jour) + MT (a 20 mg/kg/jour) + GEN. Nous avons ensuite determine le poids des reins, les concentrations seriques de creatinine et d'uree, les concentrations renales des derives reactifs de l'oxygene (ROS), de malondialdehyde (MDA) et de glutathion (GSH), ainsi que l'activite de la superoxyde dismutase (SOD) et de la catalase (CAT). Nous avons observe que la nephrotoxicite induite par la GEN etait caracterisee par une hausse marquee des concentrations seriques d'uree et de creatinine, du poids des reins, des concentrations renales de ROS et de MDA et par un abaissement des concentrations renales de GSH ainsi que de l'activite de la SOD et de la CAT. Le pretraitement par la MT a nettement inhibe l'augmentation des concentrations seriques de creatinine, du poids des reins et des concentrations renales de ROS et de MDA, mais l'administration d'ATO n'a pas permis d'obtenir un abaissement des valeurs de ces parametres. Par contre, de maniere similaire a celle de la MT, celle-la a permis d'obtenir une augmentation des concentrations renales de GSH ainsi que de l'activite de la CAT et de la SOD. De plus, le traitement d'association par la MT + ATO a ete plus benefique que le traitement par l'ATO seule, sans toutefois modifier ou meme ameliorer les effets de l'administration de la MT. En somme, la presente etude montre que le traitement d'association par la MT + ATO pourrait attenuer les lesions renales chez le rat traite par la GEN, possiblement en passant par une reduction du stress oxydatif et que la MT pourrait accroitre les effets benefiques de l'ATO. [Traduit par la Redaction] Mots-cles: melatonine, atorvastatine, gentamicine, nephrotoxicite, stress oxydatif, rats., Introduction Gentamicin (GEN), an aminoglycoside, was first isolated from Gram-positive bacteria, Micromonospora purpurea, and it has antibiotic activity against various gram-negative microorganisms and widely applied for treatment of life-threatening gram-negative [...]

Introduction. Renal disorders have been reported as the underlying cause as well as complications of critical COVID-19 in pediatric patients. The purpose of this study was to investigate the pattern of kidney involvement, particularly acute kidney injury (AKI), among pediatric patients with COVID-19. Methods. In this prospective study, hospitalized pediatric patients with a clinical diagnosis of COVID-19 were enrolled. Demographic, clinical, and laboratory findings were collected and analyzed using a mixed method of qualitative and quantitative approaches and descriptive statistics. Results. One hundred and eighty-seven patients, including 120 (64.2%) males and 67 (35.8%) females with COVID-19 with a median age (interquartile range) of 60 (24 to 114) months were enrolled in this study. Most patients (n = 108, 58.1%) had one or two underlying comorbidities, mainly malnutrition (77.4%), neurologic/learning disorders (21.4%), and malignancy (10.2%). According to the Kidney Disease Improving Global Outcomes (KDIGO) classification, AKI was detected in 38.5% of patients (stage 1: 55.6%, stage 2: 36.1%, and stage 3: 8.3%) at presentation or during hospitalization. Nine patients (4.8%) required hemodialysis and 16 (8.6%) eventually died. There was no significant association between AKI and admission to the pediatric intensive care unit (PICU) (P > .05), a multisystem inflammatory syndrome in children (MIS-C) (P > .05), comorbidities (P > .05), and mortality rate (P > .05). Conclusion. Kidneys are among the major organs affected by COVID-19. Although kidney abnormalities resolve in the majority of pediatric COVID-19 infections, particular attention should be paid to serum creatinine and electrolyte levels in patients affected by COVID-19, particularly children with a history of malnutrition and kidney disorders. [ABSTRACT FROM AUTHOR]