Mortality and costs of acute renal failure associated with amphotericin B therapy.
To assess the mortality and resource utilization that results from acute renal failure associated with amphotericin B therapy, 707 adult admissions in which parenteral amphotericin B therapy was given were studied at a tertiary-care hospital. Main outcome measures were mortality, length of stay, and costs; we controlled for potential confounders, including age, sex, insurance status, baseline creatinine level, length of stay before beginning amphotericin B therapy, and severity of illness. Among 707 admissions, there were 212 episodes (30%) of acute renal failure. When renal failure developed, the mortality rate was much higher: 54% versus 16% (adjusted odds of death, 6.6). When acute renal failure occurred, the mean adjusted increase in length of stay was 8.2 days, and the adjusted total cost was $29,823. Although residual confounding exists despite adjustment, the increases in resource utilization that we found are large and the associated mortality is high when acute renal failure occurs following amphotericin B therapy.
Division of General Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. dbates@partners.org
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Bates
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D T
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Yu
G M
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Chertow
D L
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Seger
D R
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Gomes
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Dasbach
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Platt
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000191:economics* / Q000401:mortality*; D000328:Adult; D000666:Amphotericin B / Q000009:adverse effects*; D000935:Antifungal Agents / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006786:Hospitals, Urban; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000935:Antifungal Agents; D000666:Amphotericin B