| Revista: | The brazilian journal of infectious diseases |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000291014 |
| ISSN: | 1413-8670 |
| Autores: | Berdichevski, Roberto Herz1 Luis, Luciano Billodre2 Crestana, Letícia3 Manfro, Roberto Ceratti |
| Instituciones: | 1Hospital de Clinicas de Porto Alegre, Divisao de Nefrologia, Porto Alegre, Rio Grande do Sul. Brasil 2Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Rio Grande, Rio Grande do Sul. Brasil 3Universidade Federal do Rio Grande do Sul, Departamento de Medicina Interna, Rio Grande, Rio Grande do Sul. Brasil |
| Año: | 2006 |
| Periodo: | Abr |
| Volumen: | 10 |
| Número: | 2 |
| Paginación: | 94-99 |
| País: | Brasil |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Caso clínico |
| Resumen en inglés | INTRODUCTION: Amphotericin B (AmphoB) is the drug of choice for treatment of severe fungal illnesses; however, it is very nephrotoxic. Modified (less toxic) amphotericins are very expensive. In low-risk patients, saline loading would be enough to prevent significant loss of renal function. MATERIAL AND METHODS: Patients with normal renal function and within the first 24 hours of treatment with AmphoB were prospectively enrolled in the study. Patients in intensive care units or who were using vasoactive drugs were excluded. Saline loads were infused before and after the AmphoB treatment. Blood and urine analyses were made at the beginning and at the end of the treatment. Serum creatinine was repeated 30 days after the end of the AmphoB treatment. RESULTS: The mean increase in serum creatinine in the 48 patients was 0.3 (0.18-0.41) mg/dL, due to a mean decrease of 25 (12.8-36.9) mL/min of creatinine clearance (CrCl). Acute renal failure, defined as an increase of more than 50% of the baseline creatinine, occurred in 15 patients (31%). Patients that were on antibiotics, in post-chemotherapy status or those submitted to bone marrow transplantation had the highest risk. Mean serum creatinine and the CrCl levels were no different from baseline values after 30 days. CONCLUSION: In low-risk patients, the use of AmphoB with prophylactic sodium chloride loading was associated with a small and reversible decrease in renal function. Due to its high cost the use of more expensive therapies for this type of patient does not seem to be justified |
| Disciplinas: | Medicina, Química |
| Palabras clave: | Nefrología, Terapéutica y rehabilitación, Química farmacéutica, Anfotericina B, Insuficiencia renal aguda (IRA), Nefrotoxicidad, Cloruro de sodio |
| Keyword: | Medicine, Chemistry, Nephrology, Therapeutics and rehabilitation, Medicinal chemistry, Amphotericin B, Acute renal failure (ARF), Nephrotoxicity, Sodium chloride |
| Texto completo: | Texto completo (Ver HTML) |
