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Mitigation of amphotericin B nephrotoxicity by mannitol
Abstract:
Renal transplant recipients are susceptible to a number of fungal infections amenable to therapy with amphotericin B, but azotaemia is an almost invariable sequel to the use of this agent. As intravenous mannitol has been shown to minimize nephrotoxicity induced by amphotericin B in dogs we treated four kidney transplant recipients who had systemic fungal infections with mannitol and amphotericin B. None showed significant reduction in renal function though a mild metabolic acidosis did develop.
Insights
This study investigated if mannitol could prevent kidney damage in renal transplant patients treated with amphotericin B for fungal infections. Results suggest mannitol may protect kidney function during this antifungal therapy.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Renal transplant recipients frequently develop fungal infections.
- Amphotericin B is a common antifungal treatment but often causes nephrotoxicity (kidney damage).
- Azotemia (elevated nitrogenous waste products in blood) is a common side effect of amphotericin B.
Purpose of the Study:
- To evaluate the efficacy of intravenous mannitol in preventing amphotericin B-induced nephrotoxicity in kidney transplant recipients.
- To assess the safety and impact of combined mannitol and amphotericin B therapy on renal function.
Main Methods:
- Four kidney transplant recipients with systemic fungal infections were treated.
- The treatment regimen included intravenous amphotericin B and intravenous mannitol.
- Renal function was monitored throughout the treatment period.
Main Results:
- None of the four patients experienced a significant reduction in renal function.
- A mild metabolic acidosis was observed in some patients.
- Mannitol appeared to mitigate the expected nephrotoxic effects of amphotericin B.
Conclusions:
- Intravenous mannitol may serve as a protective agent against amphotericin B-induced nephrotoxicity in renal transplant recipients.
- This therapeutic approach shows promise for managing fungal infections in this vulnerable patient population without compromising kidney function.
- Further research is warranted to confirm these findings in larger cohorts.