Amphotericin B is the gold standard for antifungal treatment for the most severe
mycoses. However, adverse effects are common, with nephrotoxicity being the most serious, occurring early in the course of treatment, and usually being reversible in most patients. Tubular damage is a well known problem associated with
amphotericin B therapy but
acute renal failure is the most serious complication. Recent studies have examined ways to ameliorate the well-known toxicities of
amphotericin B. A new approach has been to complex the
drug with
lipids or entrap it in
liposomes. This review will concern
amphotericin B-induced nephrotoxicity, whose mechanisms are not completely clear. Nephrotoxicity seems related to direct
amphotericin B action on the renal tubules as well as to
drug-induced renal vasoconstriction. The main mechanisms of nephrotoxicity suggested in the literature are presented. The clinical picture at different ages (adults, children, newborns), interactions of clinical significance, strategies for prevention of
amphotericin B-induced nephrotoxicity are summarized. To provide optimal patient care, it is imperative that the clinician understand the etiology of and the signs and symptoms associated with nephrotoxicity, as well as interventions to prevent nephrotoxicity in patients receiving
amphotericin B.