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Nephrotoxicity of Amphotericin B

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Article1 August 1964Nephrotoxicity of Amphotericin BEarly and Late Effects in 81 PatientsWILLIAM T. BUTLER, M.D., JOHN E. BENNETT, M.D., DAVID W. ALLING, M.D., PH.D., PAUL T. WERTLAKE, M.D., JOHN P. UTZ, M.D., GEORGE J. HILL II, M.D.WILLIAM T. BUTLER, M.D., JOHN E. BENNETT, M.D., DAVID W. ALLING, M.D., PH.D., PAUL T. WERTLAKE, M.D., JOHN P. UTZ, M.D., GEORGE J. HILL II, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-2-175 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAmphotericin B is the only available drug effective in preventing death from a number of systemic fungal infections. As a result, the drug is widely used despite toxic properties that in other circumstances would render it unacceptable. Important among these toxic effects are impairment of renal function and damage to renal structure.It has been reported that azotemia, decreased renal concentrating power, and decreased phenolsulfonphthalein excretion occur in about three fourths of the patients during the course of administration of amphotericin B (1-7). The significance of the nephrotoxicity of amphotericin B is emphasized by the fact that the daily dose...References1. WINN WA: Seminar on mycotic infections. The use of amphotericin B in the treatment of coccidioidal disease. Amer. J. Med. 27: 617, 1959. CrossrefMedlineGoogle Scholar2. ABERNATHYJANSEN RSGT: Therapy with amphotericin B in North American blastomycosis. Ann. Intern. Med. 53: 1196, 1960. LinkGoogle Scholar3. BEARDRICHERTTAYLOR HWJHRR: The treatment of deep mycotic infections with amphotericin B, with particular emphasis on drug toxicity. Amer. Rev. Resp. Dis. 81: 43, 1960. CrossrefMedlineGoogle Scholar4. 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Observations with special reference to asymptomatic proteinuria. Arch. Intern. Med. (Chicago) 108: 739, 1961. CrossrefMedlineGoogle Scholar17. HOLEMANEINSTEIN CWHE: Studies on the toxicology of amphotericin B, in Coccidioidomysosis Cooperative Study. Transactions of the Sixth Annual Meeting of the VA-Armed Forces Coccidioidomycosis Cooperative Study, Nov. 30 and Dec. 1, 1961, pp. 36-37. Google Scholar18. HILLBUTLERWERTLAKEUTZ GJWTPTJP: The renal histopathology in amphotericin B toxicity in man and the dog (abstract). Clin. Res. 10: 249, 1962. Google Scholar19. BERMANIOVINEHALIKIS LBGD: The amphotericin kidney. Clin. Res. 11: 120, 1963. Google Scholar20. REYNOLDSTOMKIEWICZDAMMIN ESZMGJ: The renal lesion related to amphotericin B treatment for coccidioidomycosis. Med. Clin. N. Amer. 47: 1149, 1963. CrossrefMedlineGoogle Scholar21. WERTLAKEBUTLERHILLUTZ PTWTGJJP: Nephrotoxic tubular damage and calcium deposition following amphotericin B therapy. Amer. J. Path. 43: 449, 1963. 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Ther. 143: 47, 1964. MedlineGoogle Scholar28. HILLBUTLERSZWEDMOORE GJWTCFSU: Lethal toxicity and doserelated azotemia due to amphotericin B in dogs. Proc. Soc. Exp. Biol. Med. 114: 76, 1963. CrossrefMedlineGoogle Scholar29. TAKACSTOMKIEWICZMERRILL FJZMJP: Amphotericin B nephrotoxicity with irreversible renal failure. Ann. Intern. Med. 59: 716, 1963. LinkGoogle Scholar30. LITTMANHOROWITZSWADEY MLPLJG: Coccidioidomycosis and its treatment with amphotericin B. Amer. J. Med. 24: 568, 1958. CrossrefMedlineGoogle Scholar31. EKNOYANROBERTS GAD: Nephrotoxicity of amphotericin B observations on the mechanism of hypokalemia. Antimicrob. Agents Chemother. 1962. 497, 1963. Google Scholar32. HARSCHLAMPEN MJO: Modification of K+ transport in yeast by the polyene antifungal antibiotic N-acetylcandidin. Biochem. Pharmacol. 12: 875, 1963. CrossrefMedlineGoogle Scholar33. KINSKY SC: Alterations in the permeability of NEUROSPORA CRASSA due to polyene antibiotics. J. Bact. 82: 889, 1961. CrossrefMedlineGoogle Scholar34. BUTLERALLINGCOTLOVE WTDWE: Effect of amphotericin B on cellular membranes. J. Clin. Invest. 43: 1265, 1964. Google Scholar35. BUTLERHILLBENNETTSZWEDCOTLOVE WTGJJECFE: Patterns of acute electrolyte response to amphotericin B in dog and man. Clin. Res. 12: 46, 1964. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Bethesda, MarylandFrom the Department of Health, Education, and Welfare, Public Health Service, National Institutes of Health, National Institutes of Allergy and Infectious Diseases, Laboratory of Clinical Investigations, Bethesda, Maryland.Requests for reprints should be addressed to William T. Butler, M.D., National Institutes of Health, Building 10, Room 11-N-232, Bethesda, Maryland 20014. Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAntifungal agents and the kidney: pharmacokinetics, clinical nephrotoxicity, and interactionsPathophysiology of Drug-Induced HypomagnesaemiaTurning weakness into strength: Albumin nanoparticle-redirected amphotericin B biodistribution for reducing nephrotoxicity and enhancing antifungal activityRenal Recovery following Liposomal Amphotericin B-Induced NephrotoxicityThe evaluation of frequency of nephrotoxicity caused by liposomal amphotericin BEfficacy and safety of amphotericin B formulations: a network meta-analysis and a multicriteria decision analysisESTRATÉGIAS TECNOLÓGICAS PARA FORMULAÇÕES DE ANFOTERICINA B EM SISTEMAS LIPÍDICOS DISPONÍVEIS NO MERCADO FARMACÊUTICO E OUTROS PROMISSORES SISTEMAS DE ADMINISTRAÇÃOHearing Loss with Amphotericin B Therapy in Patients with Rhinocerebral Aspergillosis: Is it a Reality?Development and characterization of oral liposomes of vegetal ceramide based amphotericin B having enhanced dry solubility and solubilityAcute Kidney Injury Induced by Antimicrobial Agents in the Elderly: Awareness and Mitigation StrategiesAmphotericin-B entrapped lecithin/chitosan nanoparticles for prolonged ocular applicationGenetic causes and gene–nutrient interactions in mammalian zinc deficiencies: Acrodermatitis enteropathica and transient neonatal zinc deficiency as examplesAntifungal PolyenesFactor Analysis in Decreased Expression of Renal Function by Liposomal-Amphotericin BToxic acute kidney injuryAnticandida Activity of the Marketed Essential Oil of Thymus Vulgaris L and its Concomitant Action with Amphotericin BAmphotericin BCryptococcosis: From Discovering the Natural Reservoir of its Etiology to the Genetic Manipulation of Cryptococcus neoformans: Milestones in Cryptococcal Research by Intramural Investigators at NIAIDAmphotericin B-Induced NephrotoxicityFungal InfectionsFluid, electrolyte and acid–base disorders associated with antibiotic therapyFUNGAL MENINGITISANTIFUNGAL AGENTSHigh‐Dose Amphotericin B with Flucytosine for the Treatment of Cryptococcal Meningitis in HIV‐Infected Patients: A Randomized TrialClinical Application and Side Effects of Antifungal AgentsCurrent Options in Antifungal PharmacotherapyAmphotericin BAntifungal AgentsClinical pharmacology of antifungal agents in pediatric patientsCauses of death in hyper-IgE syndromeAntibacterial and Antifungal AgentsConcomitant drugs with exposure to contrast mediaEffects of hydration with salt repletion on renal toxicity of conventional amphotericin B empirical therapy: a prospective study in patients with hematological malignanciesComparison of the effect of amphotericin B desoxycholate and amphotericin B colloidal dispersion on renal functions and renal morphology in ratsAcute renal failure after myeloablative hematopoietic cell transplant: Incidence and risk factorsAntifungal effect of various essential oils against Candidaalbicans . Potentiation of antifungal action of amphotericin B by essential oil from Thymus vulgarisAmphotericin B Nephrotoxicity in ChildrenADENOVIRUS NEPHRITIS IN HEMATOPOIETIC STEM-CELL TRANSPLANTATIONGuidelines for the use of antifungal agents in the treatment of invasive Candida and mould infectionsAntifungal therapy for keratomycosesOral candidiasis in hematopoietic cell transplantation patients: an outcome-based analysisAmphotericin BMathematical modelling of antifungal actionAntifungal effect of Hevea brasiliensis latex with various fungi. Its synergistic action with amphotericin B against Candida albicansRenal dysfunction in allogeneic hematopoietic cell transplantationCharacterizing and Predicting Amphotericin B–Associated Nephrotoxicity in Bone Marrow or Peripheral Blood Stem Cell Transplant RecipientsEnhanced antifungal activity of ketoconazole by Euphorbia characias latex against Candida albicansTreatment of Postkeratitis Fusarium Endophthalmitis with Amphotericin B Lipid ComplexEfficacy and safety of Amphotericin B Lipid Complex Injection (ABLC) in solid-organ transplant recipients with invasive fungal infectionsAntimycoticsUse of Amphotericin B Colloidal Dispersion in ChildrenAmphotericin B colloidal dispersionThe Kidney in SepsisAmiloride for the Prevention of Amphotericin B–Induced Hypokalemia and HypomagnesemiaAn Evaluation of Pharmacological Strategies for the Prevention and Treatment of Acute Renal FailureClinical Significance of Nephrotoxicity in Patients Treated with Amphotericin B for Suspected or Proven AspergillosisA Randomized Prospective Trial of Amphotericin B Lipid Emulsion Versus Dextrose Colloidal Solution in Critically III PatientsLipid amphotericin B combinations; 'la crème de la créme'?Lung Cancer, Proptosis, and Decreased VisionAntifungal Agents. Part I. Amphotericin B Preparations and FlucytosineIs Liposomal Amphotericin B (Ambisome) an Effective Prophylaxis of Mycotic Infections After Liver Transplantation?Treatment of Invasive Fungal Infections in Renally Impaired Patients with Amphotericin B Colloidal DispersionPeritonitis in Paediatric Continuous Peritoneal DialysisToxic NephropathyDrug-induced acute renal failureAmphotericin BClinical Pharmacology of Systemic Antifungal Agents: A Comprehensive Review of Agents in Clinical Use, Current Investigational Compounds, and Putative Targets for Antifungal Drug DevelopmentAcute renal failure following bone marrow transplantationA Randomized, Double-Blind, Placebo-Controlled, Phase III Study of Filgrastim in Remission Induction and Consolidation Therapy for Adults With De Novo Acute Myeloid LeukemiaAmphotericin B is superior to sodium antimony gluconate in the treatment of Indian post-kala-azar dermal leishmaniasisAbstracts of Papers Presented at Branch Conferences in 1996Amphotéricine B déoxycholate (Fungizone®): vieux médicament, nouvelles versionsSafety of amphotericin B colloidal dispersionAntimycotic Therapy with Liposomal Amphotericin-B for Patients Undergoing Bone Marrow or Peripheral Blood Stem Cell TransplantationFluconazole vs. Amphotericin B for the Treatment of Neonatal Fungal Septicemia: A Prospective Randomized TrialMedical mycologyAdministration of amphotericin B in lipid emulsion decreases nephrotoxicityIs There a Therapeutic or Pharmacokinetic Rationale for Amphotericin B Dosing in Systemic Candida Infections?Administration of Lipid-Emulsion Versus Conventional Amphotericin B in Patients with NeutropeniaExperience with liposomal Amphotericin-B in 60 patients undergoing high-dose therapy and bone marrow or peripheral blood stem cell transplantationAdverse effects of sodium restriction with concurrent medication useAmphotericin B Toxicity Reduced by Administration in Fat EmulsionEfficacy and Toxicity of Amphotericin B Liposomal and Lipid FormulationsEarly detection of amphotericin B induced nephrotoxicity by 99mTc-DTPA: a useful testNew antifungal compounds and strategies for treatment of invasive fungal infections in patients with neoplastic diseasesAntifungal chemotherapyTubular causes of renal failureAcute renal failure in the setting of bone marrow transplatationProceedings of the American Society of Pediatric Nephrology 1993 Education Symposium, Washington, D. C., 4 May, 19938 Hyponatraemia in AIDSIntralipid in Prophylaxis of Amphotericin B NephrotoxicityAntifungal drugs on the horizonSurvival factors in rhino-orbital-cerebral mucormycosisLiposomal amphotericin B, AmBisomeAntifungal agents: An overview. Part IUse of Antifungal Therapy in Hospitalized Patients I. Results Prior to the Marketing of FluconazoleUse of Antifungal Therapy in Hospitalized Patients II. Results after the Marketing of FluconazoleAre incremental doses of amphotericin B required for the treatment of visceral leishmaniasis?Hyponatremia in hospitalized patients with the acquired immunodeficiency syndrome (AIDS) and the AIDS-Related complexAcute and chronic effects of flucytosine on amphotericin B nephrotoxicity in ratsTrial of glucose versus fat emulsion in preparation of amphotericin for use in HIV infected patients with candidiasis.Clinical evaluation of a new lipid-based delivery system for intravenous administration of amphotericin BComparison of nephrotoxicities of different polyoxyethyleneglycol formulations of amphotericin B in ratsDirect amphotericin B-mediated tubular toxicity: Assessments of selected cytoprotective agentsCryptococcal Infection in AIDSImmunocompromised Host InfectionsA comparison between fluconazole tablets and clotrimazole troches for the treatment of thrush in HIV infectionAmphotericin B and Sodium Deoxycholate Induced Impairment of Renal p-Aminohippurate Accumulation (PAH) and Effect on Lipid Peroxidation in the Rat KidneyEffect of flueytosine on renal function in the ratEffect of salt supplementation on amphotericin B nephrotoxicityToxicities of Antimicrobial Agents Used to Treat OsteomyelitisInvasive aspergillosis in immunosuppressed patients: potential hazard of hospital building work.Correction: Major maxillofacial injuriesSodium Loading Treatment for Amphotericin B-Induced NephrotoxicityAcute, rapidly progressive renal failure with simultaneous use of amphotericin B and pentamidinePentoxifylline in amphotericin B toxicity rat modelAntifungal therapy in oropharyngeal mycotic infectionsSystemische Candidose bei Intensivpatienten nach Antibiotika-TherapieCryptococcose bei AIDS: Therapeutische KonzepteRisk factors for amphotericin B-associated nephrotoxicityPrevention of amphotericin-B-induced nephrotoxicity by loading with sodium chloride: A report of 1291 days of treatment with amphotericin B without renal failureSodium status influences chronic amphotericin B nephrotoxicity in ratsAcute Renal Failure Following Bone Marrow Transplantation: A Retrospective Study of 272 PatientsCryptococcosisChemotherapy for systemic mycosesToxische NierenschädenPharmacological Considerations for Renal Failure and DialysisStimulation of Lymphoproliferation by Sucrose EstersCryptococcal meningitis: seven years of maintenance amphotericin therapy without progressive renal failureCharacterization of Candida isolates from pediatric burn patientsAnfotericina B no tratamento da neurocriptococose em pacientes submetidos a transplante renalFluconazole Penetration into Cerebrospinal Fluid in HumansBurn SepsisNephrotoxic drugsToxic NephropathiesAntifungal agents in dermatologyToxicity of amphotericin B plus flucytosine in 194 patients with cryptococcal meningitisAmphotericin-b nephrotoxicity in humans decreased by sodium supplements with coadministration of ticarcillin or intravenous salineRenal Injury from Chemotherapeutic AgentsAmphotericin B and Amphotericin B methylester: Effect on brush border membrane permeabilityOto-laryngeal histoplasmosisNonoliguric Acute Renal FailureCandida infection in severe burnsAmphotericin—How Safe and Effective?The effect of amphotericin B on 67ga biodistributionRenal magnesium wasting associated with amphotericin B therapyAntimycotic therapy: A critical appraisalMechanisms of Drug NephrotoxicityPediatric Antifungal ChemotherapyBilateral Pulmonary Infiltrates in an 11-Year-Old with Acute Lymphocytic LeukemiaChemotherapie der Aspergillenkrankheiten der Lunge*Antifungal ChemotherapyFungal Infections in the Immunocompromised HostPharmacological Aspects of Renal Failure and DialysisAn internally-standardized assay for amphotericin B in tissues and plasmaThese articles bring the series to an end. We renew our thanks to Professor Geddes for generous help with planning and presentation.Antibiotic NephrotoxicityChemotherapy of the Systemic MycosesSODIUM DEPLETION ENHANCES NEPHROTOXICITY OF AMPHOTERICIN BVANCOMYCIN INDUCED NEUTROPENIAWhether or not to Administer Amphotericin to an Immunosuppressed Patient with Hematologic Malignancy and Undiagnosed FevertCandida infection in surgical patientsSTRUCTURE SIDE-EFFECT SORTING OF DRUGS.A Review of Complications of Amphotericin-B Therapy: Recommendations for Prevention and ManagementStrategies in the Treatment of Systemic Fungal InfectionsDrug-Associated NephropathyDrug-Associated NephropathyLack of effect of amphotericin B on urine-bloodpCO2 gradient in spite of urinary acidification defectPharmacologic Aspects of Regular Dialysis TreatmentDiagnosis and Treatment of Systemic MycosesAdverse reactions to anti-infective agentsErythropoietin Concentration in Amphotericin B-Induced AnemiaExistence of Sporothrix schenckii as a Pulmonary SaprophyteRhinocerebral mucormycosisOcular and orbital phycomycosisThe Nephrotoxicity of Antimicrobial AgentsExperience with amphotericin-B in the treatment of systemic candidiasis in burn patients3 Biological Activity of Polyene AntibioticsHamycin: Separation of toxicity and antifungal activity in miceCan Mannitol Reduce Amphotericin B Nephrotoxicity? Double-Blind Study and Description of a New Vascular Lesion in KidneysPSEUDOMEMBRANOUS COLITIS AFTER AMOXYCILLINANTAGONISM BETWEEN MICONAZOLE AND AMPHOTERICIN BSystemic candidiasis and endophthalmitis in neurosurgical patientsCombined Flucytosine — Amphotericin B Treatment of CryptococcosisMucocutaneous leishmaniasis: a review of clinical aspectsDiagnosis and treatment of cutaneous fungus diseasesThe surgical treatment of pulmonary coccidioidomycosisCriptococose do sistema nervoso central: experiência atual do Serviço de Neurologia da Escola Paulista de MedicinaUntoward Effects of Antimicrobial Agents on Major Organ SystemsChemotherapy of Systemic MycosesCryptococcosis and 5-FluorocytosineOn the anatomy of amphotericin B-cholesterol pores in lipid bilayer membranesAmphotericin B Methyl Ester Hydrochloride and Amphotericin B: Comparative Acute ToxicityRhinocerebral phycomycosis (mucorymycosis)Mucormycosis-Changing StatusNephrotoxicity of amphotericin B, with emphasis on changes in tubular functionProblem ClinicSurvival of candida septicaemia treated with amphotericin BProgressive Disseminated Histoplasmosis A Prospective Study of 26 PatientsJAMES W. SMITH, M.D., JOHN P. UTZ, M.D., F.A.C.P.5-Fluorocytosine in the Treatment of Cryptococcal and Candida MycosesROBERT J. FASS, M.D., ROBERT L. PERKINS, M.D., F.A.C.P.HistoplasmosisCryptococcosisHistoplasmosisCryptococcosisRENAL CANDIDIASIS: A Cause of AnuriaThe Treatment of Blastomycosis with Amphotericin BInvasive fungal infections in children: advances and perspectivesAmphotericin B Toxicity A Follow-up Report of 53 PatientsRAYMOND P. MILLER, M.D., JOSEPH H. BATES, M.D., F.A.C.P.Amphotericin B therapy in childrenSuccessful Treatment of Chronic Esophageal Moniliasis with a Viscous Suspension of NystatinHistoplasmosisDie HistoplasmoseNephrotoxic effects of amphotericin B, including renal tubular acidosisCryptococcosis: Current statusResidua from Systemic Candidiasis Treated with AmphotericinTreatment of disseminated mycotic infectionsAmphotericin b Therapy in the Treatment of Presumed Histoplasma ChorioretinitisAntifungal AntibioticsRenal Tubular Acidosis Due to Amphotericin BAlternate-Day Amphotericin B Therapy in the Treatment of Rhinocerebral Phycomycosis (Mucormycosis)DENNIS J. BATTOCK, M.D., HENRY GRAUSZ, M.D., MARTIN BOBROWSKY, M.D., MAXWELL L. LITTMAN, M.D., PH.D.The Significance of CandidemiaCHARLES A. ELLIS, M.D., MARTIN L. SPIVACK, M.D., PH.D.A to of in Patients with Renal A of and M.D., Phycomycosis in with Report of and a Review of Clinical and Experience with Amphotericin B M.D., M.D., A. with an oral Infections of to and the Amphotericin N. M.D., August August by The American of

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