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Are salt loading and prolonging infusion period effective in prevention of amphotericin B-induced nephrotoxicity?

Iman Karimzadeh1, Shadi Farsaei, Hossein Khalili

  • 1Tehran University of Medical Sciences, Faculty of Pharmacy, Department of Clinical Pharmacy, Tehran, Iran. khalilih@tums.ac.ir

Expert Opinion on Drug Safety
|September 7, 2012
PubMed
Abstract

Insights

Salt loading effectively prevents amphotericin B-induced kidney damage by reducing serum creatinine and improving glomerular filtration rate. However, prolonging amphotericin B infusion duration shows controversial results for preventing nephrotoxicity.

Area of Science:

  • Pharmacology
  • Nephrology
  • Infectious Diseases

Background:

  • Amphotericin B is a critical antifungal agent, but its use is limited by significant nephrotoxicity, affecting up to 80% of patients within two weeks.
  • Decades of research have focused on mitigating amphotericin B-induced renal damage.

Purpose of the Study:

  • To review clinical data on interventions for preventing amphotericin B-induced nephrotoxicity in humans.
  • To assess the efficacy of various preventive measures against amphotericin B-related kidney injury.

Main Methods:

  • A comprehensive literature search was conducted across major databases including Scopus, Medline, Embase, and the Cochrane Library.
  • Keywords focused on amphotericin B, nephrotoxicity, renal dysfunction, and preventive interventions.

Main Results:

  • Salt loading demonstrated a clear benefit in preventing or reducing serum creatinine increases and glomerular filtration rate decline in human studies.
  • Salt loading did not show efficacy in preventing tubular toxicity associated with amphotericin B.
  • Data on prolonging amphotericin B infusion duration for nephrotoxicity prevention remains controversial and presents practical challenges.

Conclusions:

  • Salt loading is a clinically validated strategy to mitigate specific aspects of amphotericin B nephrotoxicity.
  • Further research and clinical consensus are needed regarding the role of infusion duration in preventing amphotericin B-induced renal impairment.

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