Department of Pharmacy, University of Miyazaki Hospital, Miyazaki, Japan.
Department of Pharmacy, University of Miyazaki Hospital, Miyazaki, Japan;, Email:
Pharmazie. 2020 Nov 1;75(11):599-601. doi: 10.1691/ph.2020.0731.
In this study, we examined patients who received liposomal amphotericin B (L-AMB) to determine the risk factors associated with nephrotoxicity before and during L-AMB treatment. In this retrospective, single-center, observational cohort study, we examined 37 patients who received L-AMB treatment between April 2018 and December 2019. Nephrotoxicity was observed in 11 (29.7%) patients. We focused on the baseline albumin level and body surface area (BSA) before L-AMB treatment. Univariate analysis showed that the BSA and baseline albumin levels in patients with nephrotoxicity were significantly higher than those in patients without nephrotoxicity. Moreover, univariate analysis showed that albumin supplementation was significantly associated with the frequency of nephrotoxicity during L-AMB treatment. Multiple logistic regression analysis revealed the following independent risk factors for nephrotoxicity before or during L-AMB treatment: baseline albumin level (odds ratio [OR] = 16.000; 95% CI 1.480-172.000; = 0.022) and albumin supplementation (OR = 40.800; 95% CI 2.210-753.000; = 0.013). In conclusion, we identified baseline albumin level and albumin supplementation as novel risk factors for L-AMB-induced nephrotoxicity.
在这项研究中，我们检查了接受脂质体两性霉素 B（L-AMB）治疗的患者，以确定在 L-AMB 治疗前后与肾毒性相关的风险因素。在这项回顾性、单中心、观察性队列研究中，我们检查了 2018 年 4 月至 2019 年 12 月期间接受 L-AMB 治疗的 37 名患者。在 11 名（29.7%）患者中观察到肾毒性。我们重点关注 L-AMB 治疗前的基线白蛋白水平和体表面积（BSA）。单因素分析显示，肾毒性患者的 BSA 和基线白蛋白水平明显高于无肾毒性患者。此外，单因素分析显示，白蛋白补充与 L-AMB 治疗期间肾毒性的发生频率显著相关。多因素逻辑回归分析显示，L-AMB 治疗前后肾毒性的独立危险因素如下：基线白蛋白水平（比值比 [OR] = 16.000；95%置信区间 1.480-172.000； = 0.022）和白蛋白补充（OR = 40.800；95%置信区间 2.210-753.000； = 0.013）。总之，我们确定了基线白蛋白水平和白蛋白补充是 L-AMB 诱导肾毒性的新的危险因素。
