Table 5.
Renal function in ABLC-treated patients with fungal infections
| Patient group | End-of-therapy renal function parameter
|
||||||||
|---|---|---|---|---|---|---|---|---|---|
| Baseline S-Cr level, median (range), Mg/dL | Change in CCr median (range), mL/min | p | Doubling of baseline S-Cr level No. (%) of patients | p | Increase in S-Cr level To ≥ 2.5 mg/dL No. (%) of patients | p | New dialysis No. (%) of patients | p | |
| All patients (N = 3514) | 1.4 (0.08−6) | −3 (−119 to 118) | – | 468 (13) | – | 412 (12) | – | 92 (3) | – |
| Age group | |||||||||
| <18 years (n−454) | 0.7 (0.1−6) | 0 (−105 to 108) | – | 71 (16) | – | 27 (6) | – | 12 (3) | – |
| ≥18 years (n = 3048) | 1.6 (0.08−6) | −3 (−119 to 118) | 0.008 | 396 (13) | 0.110 | 385 (13) | <0.001 | 80 (3) | 0.975 |
| Status prior to start of ABLC therapya | |||||||||
| Refractoryb (n = 1411) | 1.2 (0.08−6) | −5 (−111 to 99) | 0.033 | 220 (16) | 0.282 | 157 (11) | 0.397 | 25 (2) | 0.209 |
| Underlying renal disease, prior antifungal therapy (n = 84) | 2 (0.3−6) | 0.5 (−107 to 52) | <0.001 | 11 (13) | 0.307 | 14 (17) | 0.056 | 4 (5) | 0.027 |
| Underlying renal disease, no prior antifungal therapy (n = 945) | 2 (0.15−6) | 0 (−99 to 118) | <0.001 | 83 (9) | <0.0091 | 133 (14) | 0.025 | 44 (5) | <0.001 |
| Intolerancec (n = 573) | 1.4 (0.2−6) | 0 (−108 to 101) | <0.001 | 60 (11) | <0.001 | 54 (9) | 0.855 | 14 (2) | 0.072 |
| No prior antifungal therapy/no renal disease (n = 431) | 1 (0.1−6) | –10 (−117 to 101) | – | 77 (18) | – | 42 (10) | – | 4 (1) | – |
| Prior treatment | |||||||||
| No prior Amb (n = 2056) | 1.3 (0.08−6) | −5 (−119 to 118) | <0.001 | 311 (15) | <0.001 | 230 (11) | 0.290 | 50 (2) | 0.408 |
| Prior AmB (n = 1398) | 1.6 (0.19−6) | 0 (−117 to 101) | – | 146 (10) | – | 173 (12) | – | 40 (3) | … |
Note: Statistical analysis was performed by using the median scores test for continuous variables and χ2 or Fisher’s exact test, as appropriate, for categorical variables.
Abbreviations: AmB, amphotericin B deoxycholate; CCr, predicted creatinine clearance; S-Cr, serum creatinine.
P values in this subsection compare each category with patients in the “no prior antifungal medication/no underlying renal disease” category.
22% of these patients also had underlying renal disease.
Intolerance included infusion-related toxicity, increasing S-Cr level, or hepatotoxicity.
Reproduced from Alexander BD, Wingard JR. 2005. Study of renal safety in amphotericin B lipid complex-treated patients. Clin Infect Dis, 40(Suppl 6):S414–S21. Copyright © 2005. University of Chicago Press. All rights reserved.