ID01 - Incidence of Acute Kidney Injury in Dogs with Systemic Infections Treated with Amphotericin B

Background—Amphotericin-B (AmB) is an essential medication for the treatment of systemic mycoses. Nephrotoxicity is a known complication of AmB treatment but the incidence and risk factors for acute kidney injury (AKI) following its administration are not known in dogs.

Objective—Determine the incidence of and risk factors for AKI in dogs receiving AmB.

Animals—51-client owned dogs receiving AmB for the treatment of systemic infections.

Methods—Retrospective study. Signalment, potential risk factors (dehydration, renal disease, recent non-steroidal anti-inflammatory drug administration, recent anesthesia, ICU hospitalization, neurologic deficits, inpatient status), AKI development (creatinine > 0.3 mg/dL from baseline), drug formulation (deoxycholate (AmB-D) or lipid complex (ABLC)), dose, and treatment duration were recorded. Incidence of AKI was determined, and odds ratios were calculated for potential risk factors.

Results—Incidence of AKI was 5/12 (41%) for dogs receiving AmB-D and 14/39 (36%) for dogs receiving ABLC. Of the 19 dogs that developed AKI, 16 (84%) continued treatment after a break in the planned dosing protocol. Median cumulative dose administered prior to first AKI was 6.9 mg/kg for AmB-D and 22.5 mg/kg for ABLC. ICU hospitalization (odds ratio (OR) 0.21, 95% confidence interval (CI) 0.58-0.87) and inpatient status (OR 0.25, and 95% CI 0.07-0.86) were associated with a decreased odds of AKI.

Conclusions and Clinical Importance—Incidence of AKI with AmB is common, but does not always preclude continued treatment. The incidence of AKI is similar between AmB-D and ABLC, but dogs receiving ABLC tolerated a higher total dose before AKI developed.