Nefrotoxicidad inducida por anfotericina B desoxicolato en pacientes adultos

Amphotericin B is a polyene antifungal used to treat invasive fungal infections and leishmaniasis. Its main adverse effect is nephrotoxicity, followed by electrolyte imbalances and infusion-related reactions. To minimize these effects, lipid formulations are recommended; however, due to their high cost, many healthcare systems favor the use of the deoxycholate form. A literature review was conducted across multiple databases to identify factors associated with nephrotoxicity induced by amphotericin B deoxycholate. The most common adverse effects were elevated nitrogenous waste products and hypokalemia, followed by anemia, infusion site pain, and phlebitis. Major risk factors included cumulative drug dose, prolonged treatment duration, advanced age, pharmacological immunosuppression, and concurrent use of other nephrotoxic drugs. The most effective preventive strategies were aggressive hydration to increase diuresis, electrolyte replacement—particularly potassium supplementation—and, in some cases, discontinuation of the drug.