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Recurrent reversible acute renal failure from amphotericin.

P Sacks, S K Fellner

Archives of Internal Medicine

|March 1, 1987

Summary

Amphotericin B can cause acute kidney injury in patients with cirrhosis and sporotrichosis. This renal dysfunction appears functional and reversible, potentially linked to tubuloglomerular feedback mechanisms.

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Area of Science:

Nephrology
Infectious Diseases
Hepatology

Background:

Disseminated sporotrichosis is a serious fungal infection.
Cryptogenic cirrhosis presents complex clinical challenges.
Amphotericin B is a critical antifungal agent.

Observation:

A patient with cirrhosis and sporotrichosis experienced acute renal failure after amphotericin B treatment.
Renal failure occurred rapidly and was reversible within days.

Findings:

The rapid onset and reversibility suggest a functional component to the renal dysfunction.
Amphotericin B may trigger tubuloglomerular feedback in patients with reduced arterial volume, leading to acute kidney injury.

Implications:

This case highlights a potential mechanism for amphotericin B-induced nephrotoxicity.
Clinicians should consider renal function monitoring in cirrhotic patients receiving amphotericin B.
Understanding tubuloglomerular feedback may inform strategies to mitigate antifungal-related kidney damage.

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