ROLE OF SODIUM LOADING AS A REMEDY FOR AMPHOTERICIN B INDUCED NEPHROTOXICITY

Sodium Loading in Amphotericin B Induced Nephrotoxicity

Abstract

Objective: This study was carried out to evaluate the protective role of sodium loading with 0.9% Normal saline against amphotericin B-induced nephrotoxicity.
Study Design: Randomized controlled study.
Place of study and Duration: Pharmacology department and animal house of Army Medical College as part of author’s M Phil research project from Feb 2011 to Oct 2011.
Material and Methods: Eighteen rabbits were used in this study. Rabbits were randomly divided into three groups. Each group contained six rabbits. Group A (Control) was injected 10 ml of 0.9% saline intraperitonially. Acute nephrotoxic single dose of amphotericin B, 4 mg/kg was given as intravenous infusion to group B rabbits, group C rabbits received same dose along with prior administration of normal saline, 10 ml/kg intraperitonially for five days. Blood samples were collected from all animals 24 hours after last dose for estimation of blood urea, serum creatinine, serum sodium and serum potassium levels. Histopathology of kidneys was also performed.
Results: Biochemical and histopathological analysis showed significant increase in blood urea and serum creatinine in group B animals that received acute nephrotoxic dose of amphotericin B. However changes in serum electrolytes were not significant. Histopathology showed marked, grade-3 nephrotoxicity. Sodium loading attenuated amphotericin B-induced nephrotoxicity significantly in group C rabbits as their blood urea and serum creatinine levels did not increase significantly in comparison to baseline levels. Histopathology showed mild nephrotoxicity of grade-1, significantly less marked than seen in group B.
Conclusion: Present study concludes that sodium chloride loading significantly reduces the nephrotoxicity of amphotericin B and can be used to mitigate amphotericin B-induced nephrotoxicity.