Liposomal amphotericin B and renal safety: review of the evidence and clinical considerations
Bibliographic record
Abstract
Invasive fungal infections continue to represent an important cause of morbidity and mortality in severely ill and immunocompromised patients. Liposomal amphotericin B (LAmB) has a significantly improved toxicity profile versus conventional amphotericin B deoxycholate and is recommended for a wide range of medically important opportunistic fungal pathogens. Although rates are significantly lower than with older formulations, nephrotoxicity with LAmB remains a concern. Risk factors for renal toxicity with LAmB include higher doses, longer duration of treatment, concomitant use of nephrotoxic agents and the presence of pre-existing kidney disease. Appropriate patient screening, individualized risk assessment, and patient monitoring may reduce the risk of renal toxicity. The prophylactic use of intravenous saline fluids is also recommended with LAmB to reduce the risk of nephrotoxicity. In addition, magnesium and potassium supplementation should be considered to reduce the risk of hypomagnesaemia and hypokalaemia, respectively. Alternate dosing strategies, including intermittent dosing and, for certain fungal infections, single-dose high-dose induction therapy, may be useful in minimizing nephrotoxicity, but additional research is necessary.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".