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Nephrotoxicity of amphotericin B in the treatment of cryptococcal meningitis in acquired immunodeficiency syndrome patients


PO Ochieng
SO McLigeyo
EO Amayo
JK Kayima
EO Omonge

Abstract

Objectives: To describe the incidence of renal dysfunction, hypokalaemia and hypomagnesaemia in AIDS patients with cryptococcal meningitis and on amphotericin B treatment. Secondary objective was to determine all-cause mortality in the same group.
Design: Prospective, observational study.
Setting: Kenyatta National Hospital (KNH), Nairobi, Kenya.
Subjects: Seventy consecutive patients with AIDS and cryptococcal meningitis on amphotericin B.
Results: About 58.6% of the patients had at least 100% rise in the creatinine level. Thirty eight point six per cent of patients experienced a rise in serum creatinine of at least 50%. Ninty three per cent of the patients developed hypokalaemia and 80% had hypomagnesaemia at trough magnesium level. Only 54.3% of patients completed the intended 14-day treatment. Thirty point five per cent of patients died within the two week follow-up period.
Conclussion: The incidences of amphotericin B associated nephrotoxicity, hypokalemia and hypomagnesaemia were high in this studied population

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eISSN: 0012-835X