Background: Although renal function is generally unaffected by liposome formulations of amphotericin B-deoxycholate, there is nevertheless a risk.
Case reports: Two patients immunodepressed patients treated for candidosis involving the mouth and esophagus unresponsive to local care and flucanazol developed renal failure when given the liposome formulation of amphotericin B-deoxycholate (AmBisome). In one with normal renal function prior to treatment, moderate impairment was observed after initiating AmBisome. In the second patient, impaired renal function worsened after initiating treatment with amphotericin B-deoxycholate then progressed to very severe renal failure after switching to AmBisome.
Conclusion: The indication for AmBisome (amphotericin B-deoxycholate treatment in patients with active renal impairment) must not overshadow the risk of worsening renal function under treatment.