amphotericin-b and Nephrocalcinosis

Several oral or intravenous drug administrations can cause abnormalities in serum magnesium concentration. Most of drug-induced hypomagnesemia derives from a loss of the mineral in the urine by facilitating renal secretion. Hypermagnesemia can occur by a direct intake of drugs including magnesium, especially in patients with renal insufficiency. Frequent check of serum magnesium concentration will be needed to monitor these abnormalities.

Topics: Amphotericin B; Cisplatin; Cyclosporine; Diuretics; Humans; Hypercalciuria; Kidney; Magnesium; Nephrocalcinosis; Proton Pump Inhibitors; Renal Tubular Transport, Inborn Errors; Warfarin

Renal morphology was studied by light and electron microscopy in 10 patients after 25 mg/kg body weight of amphotericin B as part of a controlled study designed to evaluate the possible protective effects of mannitol against the nephrotoxicity of amphotericin B. Five patients received amphotericin B 1 mg/kg body weight every other day and five received amphotericin B and mannitol 1 g/kg body weight in the infusion. Small arterial and arteriolar changes were present in all biopsies and were characterized by focal vacuolization of medial smooth muscle cells. Electron microscopy suggested formation of these vacuoles by fusion of dilated endoplasmic reticulum. A few small vacuoles were also seen in renal biopsies of age matched patients who did not receive amphotericin B. Vacuoles in biopsies of the amphotericin treated patients were considerably larger (P less than 0.001) and much more numerous (P less than 0.001) than in controls. It is hypothesized that the vacuoles in the amphotericin B treated group represent the morphologic effect of intrarenal vasoconstriction caused by amphotericin B therapy. Nephrocalcinosis was observed in all biopsies and appeared to originate by precipitation of calcium salts in tubular casts.

Topics: Adult; Aged; Amphotericin B; Arterioles; Endoplasmic Reticulum; Female; Humans; Kidney; Kidney Tubules; Male; Mannitol; Middle Aged; Muscle, Smooth; Nephrocalcinosis; Vacuoles

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

Topics: Adult; Amphotericin B; Brain; Cryptococcosis; Diagnosis, Differential; Heart Diseases; Humans; Lung; Male; Meningitis; Nephrocalcinosis; Prednisolone; Sarcoidosis; Sepsis

Topics: Amphotericin B; Blood Urea Nitrogen; Dogs; Gastrointestinal Diseases; Kidney; Kidney Glomerulus; Kidney Tubules; Nephrocalcinosis; Pathology; Pharmacology; Pyelonephritis; Research; Toxicology; Urea

Topics: Amphotericin B; Humans; Nephrocalcinosis; Sporotrichosis; Toxicology