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Association between the hypokalaemia index based on area over the serum potassium concentration curve and occurrence of acute kidney injury in patients administered liposomal amphotericin B.
Ueda, Takashi; Nakajima, Kazuhiko; Ichiki, Kaoru; Ishikawa, Kaori; Yamada, Kumiko; Tsuchida, Toshie; Otani, Naruhito; Takubo, Shingo; Iijima, Kosuke; Uchino, Motoi; Horio, Yuki; Kuwahara, Ryuichi; Kimura, Takeshi; Murakami, Yasushi; Nozaki, Yasuhiro; Nakama, Soichiro; Miyazaki, Yoshitsugu; Takesue, Yoshio.
Afiliación
  • Ueda T; Department of Infection Prevention and Control, Hyogo Medical University Hospital, Nishinomiya, Japan.
  • Nakajima K; Department of Infection Prevention and Control, Hyogo Medical University Hospital, Nishinomiya, Japan.
  • Ichiki K; Department of Infection Prevention and Control, Hyogo Medical University Hospital, Nishinomiya, Japan.
  • Ishikawa K; Department of Infection Prevention and Control, Hyogo Medical University Hospital, Nishinomiya, Japan.
  • Yamada K; Department of Infection Prevention and Control, Hyogo Medical University Hospital, Nishinomiya, Japan.
  • Tsuchida T; Department of Clinical Technology, Hyogo Medical University Hospital, Nishinomiya, Japan.
  • Otani N; Department of Infection Prevention and Control, Hyogo Medical University Hospital, Nishinomiya, Japan.
  • Takubo S; Department of Infection Prevention and Control, Hyogo Medical University Hospital, Nishinomiya, Japan.
  • Iijima K; Department of Pharmacy, Hyogo Medical University Hospital, Nishinomiya, Japan.
  • Uchino M; Department of Clinical Technology, Hyogo Medical University Hospital, Nishinomiya, Japan.
  • Horio Y; Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery, Hyogo Medical University, Nishinomiya, Japan.
  • Kuwahara R; Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery, Hyogo Medical University, Nishinomiya, Japan.
  • Kimura T; Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery, Hyogo Medical University, Nishinomiya, Japan.
  • Murakami Y; Department of Pharmacy, Hyogo Medical University Hospital, Nishinomiya, Japan.
  • Nozaki Y; Department of Respiratory Medicine, Tokoname City Hospital, Tokoname, Japan.
  • Nakama S; Department of Respiratory Medicine, Tokoname City Hospital, Tokoname, Japan.
  • Miyazaki Y; Department of Clinical Infectious Diseases, Tokoname City Hospital, Tokoname, Japan.
  • Takesue Y; Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan.
Mycoses ; 67(7): e13771, 2024 Jul.
Article en En | MEDLINE | ID: mdl-39031945
ABSTRACT

BACKGROUND:

Acute kidney injury (AKI) and hypokalaemia are common adverse events after treatment with liposomal amphotericin B (L-AMB).

OBJECTIVES:

Because excess potassium (K) leakage occurs during renal tubular injury caused by L-AMB, measuring the decrease in rate of serum K concentration might be more useful to assess the renal impact of L-AMB than hypokalaemia identified from a one-point measurement. The effects of a decrease in K concentration and duration of hypokalaemia on AKI were investigated.

METHODS:

A ≥ 10% decrease in K concentration from the reference concentration within a 7-day timeframe was evaluated. The hypokalaemia index, which combines the duration of K concentration lower than the reference and a marked low K concentration, was calculated from the area over the concentration curve.

RESULTS:

Eighty-six patients were included in the study. The incidences of AKI and decrease in K concentration were 36.0% and 63.9%, respectively. Of patients who developed both adverse events, a decrease in K concentration occurred first in 22 of 26 patients, followed by AKI 7 days later. Hypokalaemia did not increase AKI risk whereas a decrease in K concentration was an independent risk factor for AKI. The hypokalaemia index in patients with AKI was significantly higher than those without AKI (5.35 vs. 2.50 points, p = 0.002), and ≥3.45 points was a significant predictor for AKI.

CONCLUSION:

A ≥ 10% decrease in the K concentration was a significant factor for AKI in patients receiving L-AMB therapy. In such patients, dose reduction or alternative antifungals could be considered based on the hypokalaemia index.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Potasio / Anfotericina B / Lesión Renal Aguda / Hipopotasemia / Antifúngicos Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Mycoses Asunto de la revista: MICROBIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Potasio / Anfotericina B / Lesión Renal Aguda / Hipopotasemia / Antifúngicos Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Mycoses Asunto de la revista: MICROBIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón