amphotericin-b and Uremia

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Cryptococcosis; Deoxycholic Acid; Drug Combinations; Fungemia; Hepatitis B, Chronic; Hepatomegaly; Herpes Zoster; Histoplasmosis; Humans; Male; Splenomegaly; Toxoplasmosis; Ultrasonography; Uremia

Topics: Amphotericin B; Antifungal Agents; Biological Availability; Fever; Humans; Kinetics; Uremia

The kidneys of newborn rats, which are both morphologically and physiologically immature, have been shown to be relatively insensitive to the nephrotoxic effects of several chemicals. To examine the specificity of these age-related differences, pups received sc injections of either 20 mg/kg of amphotericin B or 250 mg/kg folic acid, two known nephrotoxins in adult animals, on postnatal Day 1, 8, or 15. Renal function was examined by a basal clearance test and a hydropenia challenge at 1, 2, or 5 (6 in the case of amphotericin B) days after treatment. We observed no difference in degree of renal toxicity with age, but repair of renal damage tended to proceed slower at the youngest age. Amphotericin treatment produced uremia, increased fractional excretion of water and sodium, a decreased fractional excretion of urea, and a diminished hydropenia response but no change in creatinine clearance and no renal pathology. The observed pattern of renal toxicity may be attributed to an inability to maintain urea gradients in the distal segment of the nephron. Folic acid treatment resulted in greatly increased kidney weights with marked pathology, uremia with decreased creatinine clearance, increased fractional excretion of water, and a decreased hydropenia response. Unlike the renal toxicity observed following amphotericin treatment, renal toxicity from folic acid appears to be a nonspecific response to cell injury within the renal tubules. The data indicate that, in general, neonates do not possess a relative insensitivity to nephrotoxins and that renal physiological measurements which can be performed in neonatal rats are useful in evaluating and interpreting alterations in renal function.

Topics: Aging; Amphotericin B; Animals; Animals, Newborn; Body Weight; Creatinine; Female; Folic Acid; Injections, Subcutaneous; Kidney; Kidney Diseases; Kidney Function Tests; Male; Organ Size; Rats; Uremia

Rhinocerebral mucormycosis is, with few exceptions, only reported in patients with severe metabolic or immunologic imbalances. Factors which may predispose to the development of mucormycosis are reviewed. These factors include ketoacidosis and immunologic deficiency states due either to the primary disease or to the treatment for other diseases. An appreciation for these predisposing factors is very important in order that aggressive diagnosis and therapy be undertaken without delay.

Topics: Acidosis; Adrenal Cortex Hormones; Aged; Amphotericin B; Anemia; Brain Diseases; Diabetes Complications; Humans; Immunologic Deficiency Syndromes; Keto Acids; Leukemia; Male; Mucormycosis; Neutropenia; Nose Diseases; Turbinates; Uremia

Renal transplant recipients are susceptible to a number of fungal infections amenable to therapy with amphotericin B, but azotaemia is an almost invariable sequel to the use of this agent. As intravenous mannitol has been shown to minimize nephrotoxicity induced by amphotericin B in dogs we treated four kidney transplant recipients who had systemic fungal infections with mannitol and amphotericin B. None showed significant reduction in renal function though a mild metabolic acidosis did develop.

Topics: Acidosis; Adult; Amphotericin B; Candidiasis; Cryptococcosis; Histoplasmosis; Humans; Injections, Intravenous; Kidney Diseases; Kidney Function Tests; Kidney Transplantation; Male; Mannitol; Middle Aged; Postoperative Complications; Transplantation, Homologous; Uremia

Topics: Amphotericin B; Anemia; Blood Transfusion; Blood Urea Nitrogen; Candida albicans; Candidiasis; Female; Humans; Infant; Iron; Leg Ulcer; Leukocyte Count; Meningitis; Uremia

Topics: Amphotericin B; Anemia; Anemia, Aplastic; Blood; Blood Transfusion; Erythrocytes; Hematocrit; Hemolysis; Humans; Iron; Nitrogen; Toxicology; Uremia

Topics: Amphotericin B; Anemia; Blood Urea Nitrogen; Bone Marrow Examination; Drug Therapy; Hematocrit; Humans; Toxicology; Uremia; Urologic Diseases

Topics: Amphotericin B; Anuria; Coccidioidomycosis; Humans; Kidney; Kidney Diseases; Kidney Function Tests; Toxicology; Uremia

Topics: Amphotericin B; Dogs; Dosage Forms; Kidney Diseases; Research; Toxicology; Uremia

Topics: Amphotericin B; Azotemia; Dogs; Drug Tolerance; Injections, Intravenous; Kidney; Nephrectomy; Physiology; Research; Toxicology; Uremia; Ureter