Is amphotericin B safe in renal failure?

Is amphotericin B safe in renal failure?

Tubular damage is a well known problem associated with amphotericin B therapy but acute renal failure is the most serious complication. Recent studies have examined ways to ameliorate the well-known toxicities of amphotericin B. A new approach has been to complex the drug with lipids or entrap it in liposomes.

Which amphotericin B formulation is the least nephrotoxic?

Authors’ conclusions: Current evidence suggests that liposomal amphotericin B is less nephrotoxic than conventional amphotericin B (when the effect on kidney function is measured as an increase in serum creatinine level equal to or greater than two-fold from the baseline level).

Does amphotericin B cause renal toxicity?

Amphotericin B-induced nephrotoxicity is manifested as azotaemia, renal tubular acidosis, impaired renal concentrating ability and electrolyte abnormalities like hypokalaemia and sodium and magnesium wasting. All these abnormalities occur to varying degrees in almost all patients receiving the drug.

How do you reduce nephrotoxicity?

How do you Prevent Nephrotoxicity?

1. Limit intake of NSAID drugs and limit painkillers.
2. Look out for words in prescription leaflet which indicate “could cause nephrotoxicity” and avoid using these drugs.
3. Use alternate drugs which are non-nephrotoxic drugs.

Which formulation of amphotericin B has highest nephrotoxicity?

In evaluating the nephrotoxicity of amphotericin B lipid complex (ABE, Abelcet™) vs. liposomal amphotericin B (AMB, Ambisome™), Tonin et al. [1] examined 2 randomised studies published between 2000 and 2001 and found a higher toxicity with ABE (OR = 3.00, 95% confidence interval (CI) = 1.65–5.45) compared with AMB.

Why is amphotericin B nephrotoxic?

Amphotericin B binds to sterols in cell membranes, thereby creating pores that compromise membrane integrity and increase membrane permeability. It binds not only to ergosterol in fungal cell walls but also to cholesterol in human cell membranes; this is what accounts for its nephrotoxicity.

How do you monitor nephrotoxicity?

Nephrotoxicity can be diagnosed through a simple blood test. Evaluation of nephrotoxicity through blood tests includes the measurements of blood urea nitrogen (BUN), concentration of serum creatinine, glomerular filtration rate and creatinine clearance.

How is amphotericin nephrotoxic?