(a) Experience in patients with prexisting renal disease
| Agent | Effects on the kidney | Dosing modifications for preexisting renal disease |
|---|---|---|
| (1) Amphotericin B | Nephrotoxic-elevation of BUN, creatinine | Sodium loading to ameliorate toxicity |
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| (2) AmBisome | Nephrotoxic | Used in pt with pre-existing renal impairment |
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| (3) ABCD | Nephrotoxic | |
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| (4) ABLC | Dose-limited renal toxicity | |
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| (5) Voriconazole | SBECD component of iv formulation | No adjustment for oral vori in pts with mild-to-severe renal impairment |
| associated with renal toxicity | I.V. should be avoided if creatinine clearance <30 mL/min | |
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| (6) Fluconazole | 50–400 mg creatinine clearance >50–100% creatinine clearance <50 (no dialysis)-adm. 50% of dose | |
| regular dialysis-admin 100% of dose after each dialysis | ||
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| (7) Itraconazole | SBECD component of iv formulation | I.V. should not be used if creatinine clearance <30 mL/min |
| associated with renal toxicity | ||
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| (8) Posaconazole | No dose adjustment for mild-to-moderate severe-monitor for breakthrough IFI |
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| (9) Anidulafungin | None | No dose adjustment, not dialyzable |
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| (10) Caspofungin | None | No dose adjustment, not dialyzable |
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| (11) Micafungin | None | No dose adjustment |