Mortality and Costs of Acute Renal Failure Associated with Amphotericin B Therapy

To assess the mortality and resource utilization that results from acute renal failure associated with amphotericin B therapy, 707 adult admissions in which parenteral amphotericin B therapy was given were studied at a tertiary-care hospital. Main outcome measures were mortality, length of stay, and...

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Bibliographic Details
Published in:Clinical infectious diseases 2001-03, Vol.32 (5), p.686-693
Main Authors: Bates, D. W., Su, L., Yu, D. T., Chertow, G. M., Seger, D. L., Gomes, D. R. J., Dasbach, E. J., Platt, R.
Format: Article
Language:English
Subjects:
Acute kidney failure
Acute Kidney Injury - chemically induced
Acute Kidney Injury - economics
Acute Kidney Injury - mortality
Adult
Amphotericin B - adverse effects
Antifungal Agents - adverse effects
Biological and medical sciences
Cohort Studies
Dosage
Drug toxicity and drugs side effects treatment
Female
Hospital admissions
Hospital Costs
Hospitalization - economics
Hospitals, Urban
Humans
Kidney failure
Length of Stay
Major Articles
Male
Medical sciences
Middle Aged
Mortality
Nephrotoxicity
Pharmacology. Drug treatments
Retrospective Studies
Teaching hospitals
Total costs
Toxicity: urogenital system
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Summary:To assess the mortality and resource utilization that results from acute renal failure associated with amphotericin B therapy, 707 adult admissions in which parenteral amphotericin B therapy was given were studied at a tertiary-care hospital. Main outcome measures were mortality, length of stay, and costs; we controlled for potential confounders, including age, sex, insurance status, baseline creatinine level, length of stay before beginning amphotericin B therapy, and severity of illness. Among 707 admissions, there were 212 episodes (30%) of acute renal failure. When renal failure developed, the mortality rate was much higher: 54% versus 16% (adjusted odds of death, 6.6). When acute renal failure occurred, the mean adjusted increase in length of stay was 8.2 days, and the adjusted total cost was $29,823. Although residual confounding exists despite adjustment, the increases in resource utilization that we found are large and the associated mortality is high when acute renal failure occurs following amphotericin B therapy.
ISSN:1058-4838
1537-6591
DOI:10.1086/319211