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Related Experiment Videos

Risk factors for amphotericin B-induced nephrotoxicity.

A D Luber1, L Maa, M Lam

  • 1University of California, San Francisco, Department of Clinical Pharmacy/School of Pharmacy, 521 Parnassus Avenue, Room C-152, San Francisco, CA 94143-0622, USA.

The Journal of Antimicrobial Chemotherapy
|March 17, 2001
PubMed
Summary
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Amphotericin B can cause kidney damage, with higher doses and other medications increasing risk. Cyclosporine is a key factor in severe cases, but no patients had permanent kidney damage in this study.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Clinical Pharmacology

Background:

  • Amphotericin B is a critical antifungal agent.
  • Nephrotoxicity is a known complication of amphotericin B therapy.
  • Risk factors for amphotericin B-induced nephrotoxicity require further characterization.

Purpose of the Study:

  • To identify risk factors associated with amphotericin B-induced nephrotoxicity.
  • To evaluate the incidence of nephrotoxicity using various definitions.
  • To inform clinical practice regarding the safe use of amphotericin B.

Main Methods:

  • Retrospective review of 178 patients receiving intravenous amphotericin B for >3 days and >100 mg cumulative dose.
  • Assessment of nephrotoxicity using five distinct definitions based on serum creatinine changes.

Related Experiment Videos

  • Multivariate analysis to determine independent risk factors for nephrotoxicity.

    • Main Results:

    • Nephrotoxicity incidence varied by definition, ranging from 8% to 50%.
    • Increased cumulative amphotericin B dose and concurrent nephrotoxic drug use were significant risk factors across all definitions.
    • Cyclosporine therapy emerged as a strong predictor of severe nephrotoxicity (OR 18.8, P=0.022).

    Conclusions:

    • Higher cumulative doses of amphotericin B and concomitant nephrotoxic medications increase the risk of kidney injury.
    • Cyclosporine use is a significant risk factor for severe amphotericin B-induced nephrotoxicity.
    • While amphotericin B can cause transient renal dysfunction, irreversible damage was not observed in this cohort, suggesting careful patient selection and monitoring are key.