An elevated pro-inflammatory cytokine response is linked to development of amphotericin B-induced nephrotoxicity.
J Antimicrob Chemother
; 68(7): 1655-9, 2013 Jul.
Article
in En
| MEDLINE
| ID: mdl-23557927
ABSTRACT
OBJECTIVES:
The underlying mechanism for amphotericin B-induced acute kidney injury (AKI) remains poorly understood and may be immunologically mediated. We assessed whether the development of nephrotoxicity is linked to a distinct cytokine profile in patients receiving amphotericin B deoxycholate (AmBD). PATIENTS ANDMETHODS:
In 58 patients who received AmBD, circulating serum interleukin (IL)-6, IL-8 and IL-10 were measured at baseline, week 1 and week 2 of antifungal treatment and correlated to the development of renal impairment. The Cox proportional hazards model approach was adopted for analysis.RESULTS:
The P value was 0.026 for the overall effect of IL-6 on time to development of AKI. An increasing or non-receding IL-6 trend by week 1 of AmBD treatment (followed by a decreasing or non-receding IL-6 trend from week 1 to week 2) correlated with an increased likelihood of nephrotoxicity [hazard ratio (HR) 6.93, P value 0.005 and HR 3.46, P value 0.035, respectively]. Similarly, persistently increasing IL-8 levels were linked to a 3.84-fold increased likelihood of AKI.CONCLUSIONS:
In patients receiving AmBD, persistence of an elevated pro-inflammatory cytokine milieu is associated with a predisposition to drug-related kidney injury.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Amphotericin B
/
Interleukin-8
/
Interleukin-6
/
Interleukin-10
/
Acute Kidney Injury
/
Antifungal Agents
Type of study:
Clinical_trials
/
Prognostic_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Antimicrob Chemother
Year:
2013
Document type:
Article
Affiliation country:
Netherlands