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The dose of the normal saline pre-infusion and other risk factors for amphotericin B deoxycholate-associated acute kidney injury Cover

The dose of the normal saline pre-infusion and other risk factors for amphotericin B deoxycholate-associated acute kidney injury

Open Access
|Dec 2023

Figures & Tables

Figure 1.

Kaplan–Meier curve of AKI-free survival for each quartile of NSS/AmBd (P = 0.03 by log-rank test for trend). AKI, acute kidney injury; NSS/AmBd, dose of normal saline pre-infusion adjusted to amphotericin B dose.
Kaplan–Meier curve of AKI-free survival for each quartile of NSS/AmBd (P = 0.03 by log-rank test for trend). AKI, acute kidney injury; NSS/AmBd, dose of normal saline pre-infusion adjusted to amphotericin B dose.

Univariate analysis to identify factors associated with AKI-free survival using the log-rank test and the log-rank test for trend

CharacteristicsMedian AKI-free survival in each subgroup (d)P
Age (quartile)>32, >35, 13, 140.65
Gender (male vs. female)8 vs. >320.01
HIV infection (yes vs. no)14 vs. >210.79
Hematologic malignancies (yes vs. no)5 vs. 160.21
Diabetes mellitus (yes vs. no)10 vs. 140.51
Cryptococcosis (yes vs. no)16 vs. 50.11
Concomitant nephrotoxics (yes vs. no)16 vs. 130.78
Body weight (quartile)17, >35, 14, 50.06
Dose of AmBd (quartile)>21, 10, 16, 50.40
NSS/BW (quartile)6, 14, >35, 170.09
NSS/AmBd (quartile)5, 14, 17, >210.03
Baseline BUN (quartile)8, 6, 14, >350.04
Baseline Cr (quartile)14, 10, 7, 180.87
Baseline CKD-EPI eGFR (quartile)18, 20, 13, 60.17
Baseline BUN/Cr ratio (quartile)5, 7, 16, 180.09
Baseline sodium (quartile)16, 8, >21, 60.25
Baseline potassium (quartile)13, 16, >35, 80.45
Baseline chloride (quartile)6, 13, 9, 170.35
Baseline bicarbonate (quartile)18, 14, 5, 60.04
Baseline magnesium (quartile)10, 18, 13, 60.67

The 14 d AKI-free survival rate in each group/quartile of the significant risk factors

Particulars14 d AKI-free survival rate (percentage without AKI)
Gender
  Male37.2
  Female63.1

NSS/AmBd (mL/mg)
  <1015.6
  10–1144.9
  11.1–14.254.2
  >14.261.4

Baseline BUN (mg/dL)
  <936.4
  9–1229.4
  13–1547.6
  >1573.4

Baseline bicarbonate (mEq/L)
  <21§65.7
  21–2247.3
  23–24§34.1
  >2440.7

Characteristics of the participants

CharacteristicsParticipants (n = 60)
Age (years)40.3 ± 13.8
Female gender27 (45.0%)
Comorbidity
HIV infection41 (68.3%)
Hematologic malignancies10 (16.7%)
Diabetes mellitus2 (3.3%)
Fungal infection
Cryptococcosis46 (76.7%)
Aspergillosis14 (23.3%)
Concomitant use of nephrotoxic drugs
Amikacin2 (3.3%)
Vancomycin5 (8.3%)
Tenofovir disoproxil fumarate4 (6.7%)
Body weight (kg)50.3 ± 10.8
Dose of AmBd (mg/kg/d)0.90 ± 0.15
Duration of AmBd therapy (d)14 (7–20)
Dose of NSS pre-infusion
  (a) Adjusted to body weight, NSS/BW (mL/kg BW)10.5 ± 2.0
  (b) Adjusted to AmBd dose, NSS/AmBd (mL/mg AmBd)11.9 ± 3.0
Baseline BUN (mg/dL)12.8 ± 5.3
Baseline Cr (mg/dL)0.77 ± 0.21
Baseline CKD-EPI eGFR (mL/min/1.73 m2)106.3 ± 23.1
Baseline BUN/Cr ratio17.3 ± 7.4
Baseline sodium (mEq/L)132.5 ± 5.6
Baseline potassium (mEq/L)3.90 ± 0.43
Baseline chloride (mEq/L)99.0 ± 5.7
Baseline bicarbonate (mEq/L)22.6 ± 3.6
Baseline magnesium (mg/dL), incomplete data (n = 40)0.79 ± 0.14
Acute kidney injury31 (51.7%)

Effect of the significant covariates on association between risk factors and AKI-free survival examined by the stratified log-rank test and the stratified log-rank test for trend

Risk factorsP value for association between risk factors and AKI-free survival

Gender-stratifiedNSS/AmBd-stratifiedBUN-stratifiedBicarb-stratified
Gender0.020.070.08
NSS/AmBd (quartile)0.040.030.02
BUN (quartile)0.020.010.04
Bicarb (quartile)0.180.040.36
DOI: https://doi.org/10.2478/abm-2023-0071 | Journal eISSN: 1875-855X | Journal ISSN: 1905-7415
Language: English
Page range: 281 - 286
Published on: Dec 28, 2023
Published by: Chulalongkorn University
In partnership with: Paradigm Publishing Services
Publication frequency: 6 issues per year

© 2023 Mathurot Virojanawat, Somkanya Tungsanga, Leilani Paitoonpong, Pisut Katavetin, published by Chulalongkorn University
This work is licensed under the Creative Commons Attribution 4.0 License.