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Ketoconazole treatment of fungal infection in acute renal failure

S Nakasato, G M Shah, R L Morrissey

    Clinical and Experimental Dialysis and Apheresis
    |January 1, 1983
    PubMed

    Insights

    This study shows ketoconazole effectively treated Candida sepsis in a diabetic patient with acute renal failure. Drug levels indicate ketoconazole is not removed by hemodialysis but absorption may change with kidney disease.

    Area of Science:

    • Internal Medicine
    • Nephrology
    • Infectious Diseases

    Background:

    • Diabetes mellitus and acute renal failure present complex clinical challenges.
    • Candida sepsis is a serious opportunistic infection, particularly in immunocompromised patients.
    • Management of infections in patients with renal impairment requires careful consideration of drug pharmacokinetics.

    Observation:

    • A patient with diabetes mellitus and acute renal failure undergoing hemodialysis developed Candida sepsis.
    • The patient was treated with the oral antifungal medication ketoconazole.
    • Plasma drug monitoring was performed during hemodialysis sessions.

    Findings:

    • Ketoconazole therapy was effective in treating the Candida sepsis.
    • Plasma ketoconazole levels during hemodialysis indicated that the drug is not removed by the dialysis process.
    • Pharmacokinetic analysis suggested that gastrointestinal absorption of ketoconazole might be altered in the setting of renal failure.

    Implications:

    • Ketoconazole can be a viable oral treatment option for Candida sepsis in patients with renal failure.
    • Hemodialysis does not significantly impact ketoconazole levels, simplifying treatment regimens.
    • Further research is warranted to fully elucidate the impact of renal failure on ketoconazole absorption and dosing.

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