{Reference Type}: Journal Article
{Title}: Association between the hypokalaemia index based on area over the serum potassium concentration curve and occurrence of acute kidney injury in patients administered liposomal amphotericin B.
{Author}: Ueda T;Nakajima K;Ichiki K;Ishikawa K;Yamada K;Tsuchida T;Otani N;Takubo S;Iijima K;Uchino M;Horio Y;Kuwahara R;Kimura T;Murakami Y;Nozaki Y;Nakama S;Miyazaki Y;Takesue Y;
{Journal}: Mycoses
{Volume}: 67
{Issue}: 7
{Year}: 2024 Jul
{Factor}: 4.931
{DOI}: 10.1111/myc.13771
{Abstract}: <B>BACKGROUND: </B>Acute kidney injury (AKI) and hypokalaemia are common adverse events after treatment with liposomal amphotericin B (L-AMB).<BR><B>OBJECTIVE: </B>Because excess potassium (K) leakage occurs during renal tubular injury caused by L-AMB, measuring the decrease in rate of serum K concentration might be more useful to assess the renal impact of L-AMB than hypokalaemia identified from a one-point measurement. The effects of a decrease in K concentration and duration of hypokalaemia on AKI were investigated.<BR><B>METHODS: </B>A ≥ 10% decrease in K concentration from the reference concentration within a 7-day timeframe was evaluated. The hypokalaemia index, which combines the duration of K concentration lower than the reference and a marked low K concentration, was calculated from the area over the concentration curve.<BR><B>RESULTS: </B>Eighty-six patients were included in the study. The incidences of AKI and decrease in K concentration were 36.0% and 63.9%, respectively. Of patients who developed both adverse events, a decrease in K concentration occurred first in 22 of 26 patients, followed by AKI 7 days later. Hypokalaemia did not increase AKI risk whereas a decrease in K concentration was an independent risk factor for AKI. The hypokalaemia index in patients with AKI was significantly higher than those without AKI (5.35 vs. 2.50 points, p = 0.002), and ≥3.45 points was a significant predictor for AKI.<BR><B>CONCLUSIONS: </B>A ≥ 10% decrease in the K concentration was a significant factor for AKI in patients receiving L-AMB therapy. In such patients, dose reduction or alternative antifungals could be considered based on the hypokalaemia index.