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

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.