European Journal of Biomedical and Pharmaceutical Sciences

LIPOSOMAL AMPHOTERICIN B INDUCED HYPOKALEMIA AND RENAL TOXICITY IN MUCORMYCOSIS PATIENTS- A RETROSPECTIVE OBSERVATIONAL STUDY

Nischala Reddy Patlolla* and Chaitanya Sathees Vidya

ABSTRACT

Introduction: Rhinocerebral mucormycosis, an aggressive and often fatal fungal infection, predominantly affects immunocompromised individuals. Liposomal Amphotericin B (L- AMB) is a preferred treatment due to its reduced nephrotoxicity compared to conventional Amphotericin B. Despite its benefits, L-AMB is associated with potential hypokalemia and renal toxicity, which necessitates careful monitoring. Methods: This retrospective observational study examined 40 patients diagnosed with mucormycosis and treated with L-AMB from May 2021 to August 2021 at Continental Hospitals, Hyderabad. The objectives were to evaluate the prevalence of hypokalemia, monitor creatinine levels for nephrotoxicity, assess survival rates, and evaluate the risk associated with diabetes. Results: Of the 40 patients, 38 tested positive for mucormycosis and were treated with L-AMB and potassium supplements. The cohort had a median age of 47.5 years, with a male-to-female ratio of 8.5:1. Hypokalemia was prevalent, with serum potassium levels significantly dropping after 3 days of treatment (average initial: 4.1 mmol/L; after 3 days: 3.3 mmol/L; final: 3.6 mmol/L). Creatinine levels exhibited minor fluctuations with no significant long-term increases (average initial: 0.9 mg/dL; after 3 days: 1.0 mg/dL; final: 0.9 mg/dL). Diabetes was a major predisposing factor, with a higher survival rate observed in patients treated with L- AMB (84% survived). Discussion: The study highlights that while L-AMB effectively treats mucormycosis, it frequently induces hypokalemia. Renal function, however, remained relatively stable, demonstrating the relative safety of L-AMB regarding nephrotoxicity. Careful monitoring and timely potassium supplementation are essential in managing these adverse effects. Conclusion: L-AMB treatment for mucormycosis is associated with significant hypokalemia but minimal renal toxicity. Regular monitoring of electrolyte levels and renal function is crucial for optimizing patient outcomes and managing potential side effects.

Keywords: Mucormycosis, Invasive fungal infection, Liposomal Amphotericin B, Hypokalemia, Renal Toxicity, Immuno-compromised.