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Risk factors for Amphotericin B-associated nephrotoxicity
M A Fisher1, G H Talbot, G Maislin
1Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.
The American Journal of Medicine
|November 1, 1989
Summary
Higher average daily doses of amphotericin B, diuretic use, and abnormal baseline renal function significantly increase nephrotoxicity risk. These findings help clinicians assess amphotericin B therapy risks for fungal infections.
Area of Science:
- Pharmacology
- Nephrology
- Infectious Diseases
Background:
- Amphotericin B is a critical antifungal agent.
- Nephrotoxicity is a significant adverse effect of amphotericin B therapy.
- Identifying risk factors is crucial for patient safety.
Purpose of the Study:
- To identify and quantify risk factors associated with amphotericin B-induced nephrotoxicity.
- To analyze the relationship between dosing variables and nephrotoxicity.
- To evaluate other potential risk factors for kidney damage.
Main Methods:
- A case-control study comparing 35 patients with amphotericin B nephrotoxicity to 60 controls.
- Analysis of amphotericin B dosing variables and other risk factors using logistic regression.
- Quantification of risk associated with dose increments, duration, weight, diuretic use, and baseline creatinine.
Main Results:
- Higher average daily doses of amphotericin B were significantly associated with increased nephrotoxicity risk.
- Diuretic use and abnormal baseline serum creatinine were identified as significant risk factors.
- Increased patient weight showed a protective effect against nephrotoxicity.
Conclusions:
- Higher average daily doses, diuretic use, and abnormal baseline renal function are key risk factors for amphotericin B nephrotoxicity.
- These findings support the development of protective interventions.
- Clinicians can use this data to better assess the risk-benefit ratio of amphotericin B treatment.