Amphotericin B nephrotoxicity: an update

Amphotericin B (AmB) is an efficient drug used for first line treatment of proven or suspected fungal infections in immunocompromised patients. Thus, it may be frequently associated with nephrotoxicity (hypokaliemia, hypomagnesemia, acute renal failure), due to renal prearteriotar vasoconstriction and direct tubular toxicity. This toxicity is reinforced in patients with identified risk factors, such as chronic renal failure, use of other nephrotoxic drugs, salt depletion and can be reduced by volemic expansion and urine alcatinization prior to drug administration. Furthermore, lipidic formulations of AmB have been developed, in order to reduce nephrotoxicity. These new molecules have shown evidence for their efficacy and safety, and could be used for the treatment of patients with a higher risk of acute renal failure. (c) 2006 Elsevier SAS. Tous droits reserves.