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Coadministration of Liposomal Amphotericin B and Contrast Medium Does Not Increase Risk of Kidney Injury

John C O'Horo1,2, Douglas R Osmon3, Omar M Abu Saleh3

  • 1Division of Infectious Diseases, Rochester, Minnesota, USA ohoro.john@mayo.edu.

Antimicrobial Agents and Chemotherapy
|May 24, 2017
PubMed

Insights

Coadministration of intravenous contrast medium and liposomal amphotericin B does not increase the risk of kidney injury in patients with fungal infections. This finding supports the safe use of both agents together when clinically necessary.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • Intravenous radiographic contrast medium and amphotericin B are frequently used in managing fungal infections.
  • Both agents have been associated with potential nephrotoxicity via similar mechanisms.
  • The safety of concurrent administration requires systematic investigation.

Purpose of the Study:

  • To evaluate the renal safety of coadministering liposomal amphotericin B and intravenous contrast medium.
  • To compare the incidence of renal injury in patients receiving both agents versus those receiving liposomal amphotericin B alone.

Main Methods:

  • Systematic review of patients receiving coadministration of liposomal amphotericin B and intravenous contrast medium within 24 hours.
  • Comparison with a control group of patients who received non-contrast medium studies.
  • Propensity score adjustment for age, baseline kidney function, and other clinical factors.

Main Results:

  • 114 cases and 85 controls were analyzed.
  • No increased risk of renal injury was observed with the coadministration of contrast medium and liposomal amphotericin B.
  • Propensity score adjustment did not alter the observed safety profile.

Conclusions:

  • Coadministration of contrast medium and liposomal amphotericin B does not pose an excess risk of renal injury.
  • This combination can be safely used when clinically indicated.
  • The findings support current clinical practice for managing fungal infections requiring both interventions.
Keywords:
computed tomographyinvasive fungal infectionkidney injury

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