[Prevention of nephrotoxicity of amphotericin B during the treatment of deep candidiasis].
Previous observations suggest that tubulo-glomerular feedback could be involved in amphotericin B nephrotoxicity. We then investigated the influence of sodium status on the occurrence of renal damage during amphotericin B therapy. A retrospective survey demonstrated that impaired renal function occurred during therapy in 67 per cent of the patients who received amphotericin B alone and in 12 per cent of the patients who received amphotericin B and ticarcillin (parenteral sodium supplement of 100-150 meq per day). Prospective studies were then undertaken both in adults and children. Intravenous sodium supplement was given intravenously as routine prophylaxis with amphotericin B therapy. In all courses amphotericin B was successfully administered without deterioration in renal function. These results support the hypothesis that parenteral sodium supplementation reduces the frequency of developing impaired renal function during amphotericin B therapy.
Jacqz
E
E
Service de Néonatologie, Hôpital Bretonneau, Paris.
Branch
R A
RA
Heidemann
H
H
Aujard
Y
Y
D000328:Adult; D000666:Amphotericin B / Q000009:adverse effects* / Q000037:antagonists & inhibitors; D002177:Candidiasis / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000187:drug effects*; D007674:Kidney Diseases / Q000139:chemically induced; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D012964:Sodium / Q000627:therapeutic use*
D000666:Amphotericin B; D012964:Sodium
Prévention de la néphrotoxicité de l'amphotéricine B au cours du traitement des candidoses profondes.