Effect of mannitol on acute amphotericin B nephrotoxicity.

This study was undertaken to examine the value of mannitol as protection against the acute nephrotoxicity of amphotericin B under controlled conditions in a reproducible model of toxicity in the dog. Eleven dogs received amphotericin B, 2.5 mg x kg-1 b. wt. by i.v. infusion over a 4-h period. Six dogs were treated with mannitol, 6.25 g, i.v. every hour and five served as controls. Urinary volume (V), inulin clearance (CIn), p-aminohippurate clearance (CPAH), and Na excretion (UNaV) were measured every hour throughout the experiment. Although a higher urinary output was maintained in mannitol-treated dogs, a progressive decline in renal function was observed in treated and in control dogs. During the 4th h, mannitol-treated dogs showed higher CIn (37.4 vs. 19.7 ml x min-1 and CPAH (95 vs. 54 ml x min-1 than controls. However, statistically the differences were barely significant. The results fail to show that mannitol offers a definite protection against amphotericin B nephrotoxicity.