Gentamicin during gestation alters glomerular basement membrane development. A drug-induced nephrotoxicity was described for neonates after gentamicin was given intraperitoneally to pregnant Wistar rats; glomerular alterations and changes in permselectivity were important. We investigated the ultrastructure of the glomerular basement membrane (GBM), the arrangement of anionic sites, and the urinary proteins at two ages, with 1-day-and 12-month-old control and prenatally exposed animals. For neonates, the pattern of glomerular differentiation was similar, anionic sites were made of heparan sulfate proteoglycans, and the GBM had the same total thickness in both groups. After transplacental gentamicin exposure, the lamina densa was larger, the laminae rarae were thinner, the density of anionic sites was increased; the levels of hydroxyproline, sulfate, and hexuronic acid in the kidney were increased; and the immunoelectrophoresis of urinary proteins was abnormal. For adults, prenatal exposure to gentamicin led to altered juxta-medullary glomeruli with a larger GBM and abundant anionic sites, especially in the lamina densa, and to a protein excretion different from that of controls. Thus, gentamicin administered during pregnancy leads to permanent alterations of the GBM with modifications of both the layers and the anionic sites, possibly because of a perturbed protein metabolism. These altered glomeruli are at risk during life and could be the starting point for a kidney disease.Analysis of drugs in relation to their safety for mother and fetus is usually restricted to gross examinations of the newborn alone. The developing kidney, considered to be resistant to nephrotoxicity (17), is rarely investigated despite the fact that renal alterations in young and puppies have been described after administration of different drugs (18,37). Only recently has there begun to emerge a perception of how alterations of the developing kidney could explain a large variety of renal disorders, especially glomerular ones (3,44,50).In contrast, for adults nephrotoxicity studies have been expanding for 2 decades mainly because kidney diseases constitute an important economic burden which could be relieved in part by prevention. Following the widespread use of aminoglycoside antibiotics, gentamicin-induced nephrotoxicity became one of the most investigated drug-induced renal injuries (7,22,24,29,43).Observations of in utero aminoglycoside-induced nephrotoxicity after antibiotics had been given to pregnant rats (20,21,(31)(32)(33) showed that, contrary to what is seen with adults, glomerular modifications are very common while tubules are less altered. Also, an abnormal proteinuria was described and a marker with a high molecular weight (anionic ferritin) was found in the urine and glomerular podocytes after being injected intravenously into neonates (42), indicating an altered permselectivity of the glomerular basement membrane (GBM) of the mature glomeruli.Renal maturation, similar in all mammals, is often termi-* Corresponding author....