Nephrotoxicity of amphotericin B in dogs: a comparison of two methods of administration

Abstract

Two methods of administration of amphotericin B were compared for their ability to produce nephrotoxicity in 12 dogs. Six dogs received six alternate day doses of amphotericin B: 1 mg/kg administered as a rapid bolus in 25 mL 5% dextrose in water. Another six dogs received alternate day treatments of the same dose of amphotericin B in 1 L 5% dextrose in water over 5 h. Both treatment groups experienced significant reductions in glomerular filtration rate, as measured by inulin clearance, 24 h endogenous creatinine clearance, serum creatinine and serum urea. This reduction in glomerular filtration rate was most marked in the group receiving the drug as a rapid bolus. The inulin clearances decreased from 3.54 +/- 0.30 mL/min/kg (means +/- SEM) on day 0 to 1.15 +/- 0.25 mL/min/kg on day 12 in the slow infusion group and from 3.24 +/- 0.25 mL/min/kg on day 0 to 0.46 +/- 0.11 mL/min/kg on day 12 in the rapid bolus group. Renal lesions characteristic of amphotericin B administration were observed in all dogs tested. The dogs which received amphotericin B as a rapid bolus had a significantly greater number of tubular lesions than the slow infusion group. Systemic side effects, such as vomiting, diarrhea and weight loss, were observed in both treatment groups but were most severe in the rapid bolus group.(ABSTRACT TRUNCATED AT 250 WORDS)