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Renal magnesium wasting associated with amphotericin B therapy
The American Journal of Medicine
|September 1, 1984
Summary
Amphotericin B treatment can cause renal magnesium wasting and hypomagnesemia in patients with fungal infections. Monitoring serum magnesium levels during therapy is recommended due to potential tubular reabsorption defects.
Area of Science:
- Nephrology
- Pharmacology
- Infectious Diseases
Background:
- Systemic fungal infections require treatment with antifungal agents.
- Amphotericin B is a common antifungal medication.
- Potential side effects of Amphotericin B on electrolyte balance are not fully understood.
Purpose of the Study:
- To investigate the effect of Amphotericin B on magnesium metabolism.
- To determine the incidence and severity of magnesium wasting during Amphotericin B therapy.
- To assess the reversibility of Amphotericin B-induced magnesium abnormalities.
Main Methods:
- Studied 10 patients with systemic fungal infections receiving Amphotericin B.
- Monitored serum magnesium levels and fractional magnesium excretion.
- Assessed magnesium levels and excretion one year post-therapy in three patients.
Main Results:
- Renal magnesium wasting and hypomagnesemia were observed by week two of therapy.
- Lowest serum magnesium and highest fractional excretion occurred by week four.
- Magnesium wasting plateaued despite continued Amphotericin B; abnormalities reversed post-therapy.
Conclusions:
- Amphotericin B can induce renal magnesium wasting, likely due to a tubular reabsorption defect.
- Routine monitoring of serum magnesium is recommended during Amphotericin B treatment.
- Magnesium wasting is reversible after Amphotericin B discontinuation.