title: Nephrotoxicity in leukemic patients receiving empirical amphotericin B and aminoglycosides.
abstract: Twelve leukemic patients (19%) receiving amphotericin B and aminoglycosides had nephrotoxicity (creatinine value greater than 2.0 mg/dl). Patients with nephrotoxicity tended to be older than patients without nephrotoxicity; gender and total amphotericin B dose were not related to nephrotoxicity. Sodium administration has previously been shown to reverse amphotericin B nephrotoxicity. In this series, among patients receiving ticarcillin at greater than or equal to 18 gm/day (93.6 mEq of sodium per day) the incidence of nephrotoxicity was significantly decreased (1/30, or 3.3%). A multivariate analysis showed that this protective effect of ticarcillin was not dependent on the fact that patients receiving ticarcillin were less likely to receive vancomycin. There were insufficient patients receiving sodium in the absence of ticarcillin to study the effect of sodium alone. However, our observations are consistent with the hypothesis that sodium can prevent renal dysfunction in this clinical situation.
authors.affiliation: Department of Medicine (Hematology), Vanderbilt University School of Medicine, Nashville, Tenn.
authors.forename: R S
authors.initials: RS
authors.lastname: Stein
authors.forename: K
authors.initials: K
authors.lastname: Albridge
authors.forename: R K
authors.initials: RK
authors.lastname: Lenox
authors.forename: W
authors.initials: W
authors.lastname: Ray
authors.forename: J M
authors.initials: JM
authors.lastname: Flexner
mesh_terms: D000328:Adult; D000617:Aminoglycosides; D000666:Amphotericin B / Q000008:administration & dosage / Q000009:adverse effects* / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control; D007938:Leukemia / Q000188:drug therapy*; D007945:Leukemia, Lymphoid / Q000188:drug therapy; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012964:Sodium / Q000008:administration & dosage / Q000494:pharmacology; D013223:Statistics as Topic; D013982:Ticarcillin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D014640:Vancomycin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D014640:Vancomycin; D000666:Amphotericin B; D012964:Sodium; D013982:Ticarcillin