title: Are salt loading and prolonging infusion period effective in prevention of amphotericin B-induced nephrotoxicity?
abstract: BACKGROUND
  Nephrotoxicity is generally considered as the most clinically significant adverse reaction of amphotericin B, and has been reported in up to 80% of amphotericin B recipients during the first 2 weeks of treatment. Numerous experimental and clinical investigations have been performed over the past 4 decades, to find appropriate interventions for preventing or minimizing the nephrotoxic effects of amphotericin B.
  
  
  METHODS
  The aim of this literature review was to collect available clinical data regarding interventions to prevent amphotericin B-induced nephrotoxicity in human populations. A literature search was performed in the following databases: Scopus, Medline, Embase, Cochrane central register of controlled trials, and Cochrane database systematic reviews. The key words used as search terms were 'amphotericin', 'amphotericin B', 'nephrotoxicity', 'renal failure', 'renal damage', 'renal dysfunction', 'renal impairment', 'prevention', 'preventive measures', and 'preventive interventions'.
  
  
  CONCLUSIONS
  Studies in humans have clearly demonstrated that salt loading can prevent or alleviate an amphotericin B-induced rise in serum creatinine, or decrease in glomerular filtration rate, without beneficial effects on tubular toxicity of amphotericin B. Current clinical data regarding the prolongation of amphotericin B duration of infusion in the prevention of nephrotoxicity is controversial and associated with several clinical and practical drawbacks.
authors.affiliation: Tehran University of Medical Sciences, Faculty of Pharmacy, Department of Clinical Pharmacy, Tehran, Iran. khalilih@tums.ac.ir
authors.forename: Iman
authors.initials: I
authors.lastname: Karimzadeh
authors.forename: Shadi
authors.initials: S
authors.lastname: Farsaei
authors.forename: Hossein
authors.initials: H
authors.lastname: Khalili
authors.forename: Simin
authors.initials: S
authors.lastname: Dashti-Khavidaki
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000009:adverse effects*; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005919:Glomerular Filtration Rate; D006801:Humans; D007262:Infusions, Intravenous; D007674:Kidney Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D007677:Kidney Function Tests; D012965:Sodium Chloride / Q000008:administration & dosage*; D013997:Time Factors
chemical_list: D000935:Antifungal Agents; D012965:Sodium Chloride; D000666:Amphotericin B; D003404:Creatinine