amphotericin-b and Nephritis

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Combined Modality Therapy; Fluconazole; Flucytosine; Humans; Infant, Newborn; Infant, Very Low Birth Weight; Kidney; Male; Nephritis; Urologic Surgical Procedures

Topics: Adult; Amphotericin B; Anemia, Sickle Cell; Bone and Bones; Diphosphonates; Female; Humans; Hypercalcemia; Kidney; Lupus Erythematosus, Systemic; Male; Middle Aged; Nephritis; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

The first documented cure of cryptococcosis with cryptococcemia is reported. The patient had systemic lupus erythematosis and had received corticosteroids and immunosuppressive drugs for diffuse proliferative nephritis. She had additional poor prognostic factors including high serum cryptococcal antigen titer, low cerebrospinal leukocyte count, and absence of anticryptococcal antibody. Pulmonary tuberculosis was diagnosed concurrently and subsequently she developed disseminated herpes zoster. During amphotericin B therapy, renal function worsened. Cure of cryptococcosis with cryptococcemia was accomplished despite multiple concurrent infections and transient worsening of renal function.

Topics: Adult; Amphotericin B; Cryptococcosis; Female; Herpes Zoster; Humans; Immunosuppressive Agents; Lupus Erythematosus, Systemic; Nephritis; Pneumonia, Viral; Tuberculosis, Pulmonary

To determine the effect of antibiotic-induced nephrotoxicity on the renal accumulation of gallium, groups of ten Sprague-Dawley rats were given intraperitoneal injections of gentamycin, amphotericin, or neomycin for a period of 16--21 days. In all cases, mild to moderate nephrotoxicity was documented by one or more of the following parameters: serum creatinine, renal weight, urine volume (renal concentrating ability), light microscopy, and electron microscopy. In none of these cases was the renal accumulation of gallium increased over control values. Consequently, diffuse renal accumulation of gallium in patients with subclinical or mild nephrotoxicity is unlikely to be related to short-term treatment with aminoglycosides or amphotericin. In such cases, the physician should seek some other clinical explanation, such as infection.

Topics: Amphotericin B; Animals; Anti-Bacterial Agents; Gallium; Gallium Radioisotopes; Gentamicins; Kidney; Male; Neomycin; Nephritis; Radionuclide Imaging; Rats

The administration of a low total dose of amphotericin B to four consecutive patients already receiving gentamicin resulted in a deterioration of renal function in all. No other cause of the renal dysfunction was apparent in three cases. It appears probable that these drugs exhibit synergistic nephrotoxicity.

Topics: Aged; Amphotericin B; Drug Therapy, Combination; Female; Gentamicins; Humans; Kidney; Leukemia, Myeloid, Acute; Male; Middle Aged; Nephritis