B. Nephrotoxicity

Acute tubular necrosis is more common in elderly patients and in those concurrently receiving amphotericin B, cephalosporins, or vancomycin. Gentamicin and tobramycin are the most nephrotoxic.  Retention of the aminoglycosides by the proximal tubular cells disrupts calcium-mediated transport processes, and this results in kidney damage ranging from mild, reversible renal impairment to severe