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- Title
Proteinuria lowers the risk of amphotericin B-associated hypokalaemia.
- Authors
Sumit Mohan; Saud Ahmed; Behzad Alimohammadi; Manasvi Jaitly; Jen-Tse Cheng; Velvie A. Pogue
- Abstract
Objectives Amphotericin B-induced nephrotoxicity is frequent, severe and associated with an increased risk of death. Patients with underlying renal disease are considered to be at high risk for amphotericin B nephrotoxicity. Amphotericin B is a molecule that is highly protein bound over a wide range of protein and drug concentrations, including those seen in patients with ≥ 3 + proteinuria. We hypothesized that amphotericin B treatment in patients with proteinuria will be associated with less hypokalaemia than patients with non-proteinuric renal disease. Methods Thirty-six subjects who received amphotericin B deoxycholate were studied retrospectively. Twenty-five patients with proteinuria Results Hypokalaemia (K+ Conclusions In our study, heavy proteinuria appears to protect the tubular luminal membrane by decreasing the luminal concentration of free drug available to bind with the membrane. Our findings redefine the patient population deemed to be at risk of developing amphotericin B nephrotoxicity. This ensures the benefit of this important antifungal treatment option to patients with heavy proteinuria who might otherwise not be administered this drug due to the presence of pre-existing kidney disease.
- Subjects
PROTEINURIA; AMPHOTERICIN B; HYPOKALEMIA; NEPHROTOXICOLOGY
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2007, Vol 60, Issue 3, p690
- ISSN
0305-7453
- Publication type
Article
- DOI
10.1093/jac/dkm220