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Amphotericin selectively increases peritoneal ultrafiltration.

J F Maher, P Hirszel, R R Bennett

    American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
    |November 1, 1984
    PubMed
    Summary
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    Amphotericin B significantly increased ultrafiltration during peritoneal dialysis in an animal model. This antifungal agent enhanced water transport without affecting solute clearance, suggesting potential clinical utility for patients with reduced ultrafiltration capacity.

    Area of Science:

    • Nephrology
    • Pharmacology
    • Membrane Transport

    Background:

    • Amphotericin B is known to alter biological membrane transport.
    • Peritoneal dialysis (PD) efficacy relies on efficient solute and water transport across the peritoneal membrane.
    • Reduced ultrafiltration capacity is a clinical challenge in PD patients.

    Purpose of the Study:

    • To investigate the effects of amphotericin B on peritoneal transport parameters in an animal model.
    • To assess the impact of amphotericin B on diffusive and convective solute transport during PD.
    • To determine if amphotericin B influences ultrafiltration and the ultrafiltration coefficient.

    Main Methods:

    • An animal model of peritoneal dialysis was utilized.
    • Amphotericin B was administered intraperitoneally at varying doses (0.5-25 mg/kg).

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  • Transport parameters including diffusive clearances (urea, phosphate, potassium) and ultrafiltration were measured and compared to control.

    • Main Results:

    • Amphotericin B did not significantly alter urea or phosphate diffusive clearances.
    • A modest increase in potassium clearance was observed.
    • Ultrafiltration significantly increased with amphotericin B, from 0.18 to 0.31 mL/kg/min, indicating enhanced water flux.
    • The ultrafiltration coefficient was higher with amphotericin B (14 microL/kg/min/mosm) compared to controls (6 microL/kg/min/mosm).
    • Dextrose transport and osmotic gradient remained unaffected.

    Conclusions:

    • Amphotericin B enhances ultrafiltration during peritoneal dialysis by increasing water flux across the peritoneal membrane.
    • The drug does not impair essential solute clearance, suggesting a specific effect on water transport.
    • Amphotericin B shows promise as a potential therapeutic agent to improve ultrafiltration capacity in PD patients.
    • Further research into safer analogues of amphotericin B for clinical application is warranted.