amphotericin-b and Nephritis--Interstitial

Topics: Amphotericin B; Antifungal Agents; Eye; Female; Humans; Hyphae; Magnetic Resonance Imaging; Middle Aged; Mucormycosis; Nephritis, Interstitial; Treatment Outcome

Topics: Amphotericin B; Anti-Bacterial Agents; Antineoplastic Agents; Contrast Media; Humans; Immunosuppressive Agents; Kidney; Metals; Mushroom Poisoning; Nephritis, Interstitial; Plant Poisoning

Drug-induced renal disease is a common problem. Drugs cause several renal syndromes, such as prerenal azotemia, fluid and electrolyte abnormalities, acute tubular necrosis, acute interstitial nephritis, and chronic interstitial nephritis. Acute renal failure due to acute tubular necrosis is the most common syndrome and is most frequently caused by aminoglycoside antibiotics, radiographic contrast agents, and amphotericin B. Avoidance of these drugs in volume-depleted or hypotensive patients with preexisting renal disease or in those receiving multiple nephrotoxic drugs is the most effective way to reduce nephrotoxicity. Acute interstitial nephritis is an immune process that is most commonly caused by penicillins, diuretics, allopurinol, nonsteroidal anti-inflammatory drugs, cimetidine, and sulfonamides. Prompt recognition of the disease and cessation of the responsible drug are usually the only necessary therapy. Chronic interstitial nephritis is most often seen after prolonged use of several different types of analgesic agents, including aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs. These patients develop recurrent papillary necrosis and eventually chronic renal failure. They are also at risk of developing transitional cell carcinomas of the urinary collecting system. Some patients who are receiving cyclosporine also develop chronic renal failure due to interstitial fibrosis.

Topics: Acute Kidney Injury; Amphotericin B; Contrast Media; Humans; Kidney Diseases; Kidney Failure, Chronic; Nephritis, Interstitial

Topics: Acute Kidney Injury; Amphotericin B; Anti-Bacterial Agents; Cephalosporins; Glomerulonephritis; Humans; Kidney Diseases; Nephritis, Interstitial; Penicillins; Polymyxins; Tetracyclines; Vasculitis

Visceral leishmaniasis (VL) due to Leishmania infantum is an endemic parasitic infection in the Mediterranean area. It most commonly affects immunosuppressed individuals, especially HIV patients and less frequently organ transplant recipients. Renal involvement seems to be frequent and is mostly associated with tubulointerstitial nephritis, as described in autopsy reports. In the 61 cases of renal transplant recipients with VL reported in the literature, renal dysfunction was noted at clinical presentation and was more frequently observed as a complication of antiparasitic therapy. However, no pathological analysis of the allograft lesions was reported. We present the case of a Swiss renal transplant recipient who developed VL after vacations in Spain and Tunisia, complicated by acute parasitic nephritis in the renal allograft 3 months after a well-conducted treatment of liposomal amphotericin B.

Topics: Acquired Immunodeficiency Syndrome; Aged; Amphotericin B; Fatal Outcome; HIV Infections; Humans; Kidney; Leishmania infantum; Leishmaniasis, Visceral; Male; Nephritis, Interstitial; Spain; Tunisia

Topics: Aminoglycosides; Amphotericin B; Anti-Bacterial Agents; Cisplatin; Contrast Media; Hemolytic-Uremic Syndrome; Humans; Kidney Tubular Necrosis, Acute; Mannitol; Methotrexate; Nephritis, Interstitial; Paraquat

A patient developed candidemia after receiving steroids and antibiotics. Subsequently, acute oliguric renal failure occurred. Renal biopsy showed multiple cortical microabscesses. These contained encapsulated ovoid Candida, budding organisms, short hyphae, and polymorphs. Adjacent tubules showed disruption of the basement membrane, infiltration by polymorphs and necrosis. There was no evidence of pelvic-calyceal obstruction by bezoar. The acute renal failure was attributed to acute candidal tubulo-interstitial nephritis, and was successfully reversed with Amphotericin.

Topics: Acute Kidney Injury; Amphotericin B; Biopsy; Candidiasis; Humans; Kidney; Male; Middle Aged; Nephritis, Interstitial

Amphotericin B in combination with mannitol was given to a patient who had mucocutaneous candidiasis and moderate renal insufficiency. Previously, amphotericin B alone had induced an abrupt increase in serum creatinine and urea nitrogen, but when mannitol was given concurrently there was no worsening of renal function. Thus, amphotericin B with mannitol appears to offer a less nephrotoxic but equally candicidal therapeutic regimen in the renal compromised patient requiring parenteral candicidal therapy.

Topics: Adolescent; Adult; Amphotericin B; Candidiasis; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Kidney; Mannitol; Nephritis, Interstitial; Nephrocalcinosis; Skin Diseases, Infectious; Transfer Factor