Role of Diuretics and Lipid Formulations in the Prevention of Amphotericin B-induced Nephrotoxicity

Overview

Journal Eur J Clin Pharmacol

Specialty Pharmacology

Date 2013 Jan 31

PMID 23361383

Citations 13

Authors

Iman Karimzadeh

Hossein Khalili

Shadi Farsaei

Simin Dashti-Khavidaki

Mohammad Mahdi Sagheb

Affiliations

Soon will be listed here.

Abstract

Purpose: To collect available clinical data to define the role of diuretics and lipid formulations in the prevention of amphotericin B (AmB)-induced nephrotoxicity (AIN) in human populations.

Method: A literature search was performed in the following databases: Scopus, Medline, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews.

Results And Conclusion: Co-administration of mannitol failed to show any clinically significant benefit in preventing AIN. Potassium-sparing diuretics, such as amiloride and spironolactone, have been shown to have beneficial effects as an alternative or adjunct to oral/parenteral potassium supplements in preventing hypokalemia due to AmB. Lipid-based formulations of AmB are clinically effective and safe in preventing AIN. However, due to their high cost and limited accessibility, these formulations are generally used as second-line antifungal therapy in cases of conventional AmB refractoriness and/or intolerance or pre-existing renal dysfunction. The potential effects of other nephroprotective agents, such as N-acetylcysteine, AIN merit further considerations and investigations.

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