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Urinary adenosine excretion in patients receiving amphotericin B
M A Carlson1, A A Ferraz, R E Condon
1Medical College of Wisconsin, Milwaukee 53226, USA.
Surgery
|February 1, 1997
Summary
Amphotericin B (AMB) infusion decreases urine output and adenosine excretion in patients. Pre-infusion saline prevents decreased adenosine excretion but not reduced urine output. Neither change predicts kidney damage.
Area of Science:
- Nephrology
- Pharmacology
- Biochemistry
Background:
- Intravenous amphotericin B (AMB) can cause kidney injury in animals, potentially via renal vasoconstriction and ischemia.
- Adenosine excretion in urine may indicate kidney ischemia.
- Pre-AMB saline administration is known to mitigate AMB-induced nephrotoxicity.
Purpose of the Study:
- To investigate if urinary adenosine excretion and oliguria serve as early markers for amphotericin B-associated renal insufficiency.
- To determine if pre-AMB saline administration prevents changes in adenosine excretion and urine output.
Main Methods:
- Twenty hospitalized patients receiving AMB had urine collected before and during infusion.
- Eleven patients received a pre-AMB saline load; nine did not.
- Urine samples were analyzed for adenosine concentration using high-pressure liquid chromatography.
Main Results:
- AMB infusion decreased urine output in both saline-treated and comparator groups.
- Urinary adenosine excretion decreased in the comparator group but remained unchanged in the saline-treated group.
- Neither the change in urine output nor adenosine excretion correlated with the development of renal insufficiency.
Conclusions:
- AMB infusion in humans reduces urine output and urinary adenosine excretion.
- Pre-AMB saline administration prevents the decrease in adenosine excretion but not the decrease in urine output.
- Observed changes in urine output and adenosine excretion do not predict the development of nephrotoxicity.