Abstract
Summary
Renal function studies were performed in five patients with disseminated fungous disease before, during, and, in one case, after treatment with amphotericin B. Early in the course of therapy, inulin and paraminohippurate (PAH) clearances decreased. The decreases in urea clearances were generally absent or less impressive than decreases in inulin clearances, and some increase in plasma urea nitrogen level was observed in each case. Later in the course of therapy, urea clearances increased often until they were similar to the inulin clearances, and plasma urea nitrogen levels fell with little change in other clearance measurements. These observations suggest that amphotericin B, in addition to its deleterious effect on glomerular filtration rate and renal plasma flow, may block reabsorption of urea and prevent establishment of a concentration gradient between the collecting duct and medullary interstitium.
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