Risk Factors Contributing to Occurrence of Hypokalemia after Liposomal-Amphotericin B Administration

知子, 松岡; 英績, 宇佐美; 知哲, 吉村; 裕子, 高田; 忠司, 安田

doi:10.5649/jjphcs.37.487

Cited by 3 publications

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“…A previous study ( 5 ) reported the risk factors contributing to the occurrence of hypokalemia following L-AMB administration. The study revealed that patient’s serum albumin levels (≥2.82 mg/dl) at the start of L-AMB administration and history of hypokalemia prior to L-AMB administration were independent risk factors significantly contributing to the occurrence of hypokalemia ( 5 ). However, proper potassium supplementation for hypokalemia had not been sufficiently investigated.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of hypokalemia and potassium supplementation during administration of liposomal-amphotericin B

Usami

Kimura

Kanematsu³

et al. 2014

Experimental and Therapeutic Medicine

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Patients prescribed liposomal-amphotericin B (L-AMB) frequently require supplemental potassium to prevent hypokalemia. The aim of this retrospective study was to examine the appropriate potassium supplementation conditions to treat hypokalemia induced by L-AMB. The subjects were 100 hematological patients who received L-AMB for the first time between April 2012 and March 2013. A total of seven patients were excluded. Of the remaining 93 patients, 48 (51.6%) were assigned to the group receiving supplemental potassium (supplementation group), and 45 (48.4%) were assigned to the group without potassium supplementation (non-supplementation group). Hypokalemia greater than grade 3 was exhibited by 50 of the 93 (53.8%) patients. Multivariate analysis revealed that the minimum serum potassium levels during L-AMB administration (≤2.98 mEq/l) were an independent factor significantly contributing to the effectiveness of potassium supplementation [odds ratio (OR), 3.62; 95% confidence interval (CI), 1.44–9.59; P<0.01]. In addition, multivariate analysis revealed that the serum potassium levels (≥2.83 mEq/l) prior to the potassium supplementation were an independent factor significantly contributing to the development of proper potassium supplementation (OR, 14.21; 95% CI, 1.95–310.72; P=0.02), and no significant difference was observed in the dosage of the potassium supplementation administered to the patients who recovered from hypokalemia and those who did not. In conclusion, it is necessary to begin potassium supplementation prior to the reduction of the serum potassium levels to <2.83 mEq/l. Potassium supplementation at an early stage of L-AMB treatment is important to prevent severe electrolyte abnormalities.

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Section: Introductionmentioning

confidence: 99%

Evaluation of hypokalemia and potassium supplementation during administration of liposomal-amphotericin B

Usami

Kimura

Kanematsu³

et al. 2014

Experimental and Therapeutic Medicine

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“…Several studies conducted in single facilities showed that potassium supplementation helps prevent hypokalemia during L-AMB treatment [ 15 , 16 ]. However, association between potassium supplementation and the occurrence of AKI in patients with hypokalemia administered L-AMB has not been well understood.…”

Section: Introductionmentioning

confidence: 99%

Association between potassium supplementation and the occurrence of acute kidney injury in patients with hypokalemia administered liposomal amphotericin B: a nationwide observational study

et al. 2021

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Background Hypokalemia and acute kidney injury (AKI) occur in patients administered liposomal amphotericin B (L-AMB), a wide-spectrum anti-fungicidal drug. However, the association between potassium supplementation and the occurrence of AKI in patients with hypokalemia who were administered L-AMB is not well understood. Methods Using nationwide claims data and laboratory data, the occurrence of AKI during L-AMB treatment was retrospectively compared between patients with hypokalemia who were or were not supplemented with potassium and between those adequately or inadequately supplemented with potassium (serum potassium levels corrected to ≥3.5 mEq/L or remained < 3.5 mEq/L, respectively) before or after L-AMB treatment initiation. Results We identified 118 patients who developed hypokalemia before L-AMB treatment initiation (43 received potassium supplementation [25 adequate and 18 inadequate supplementation] and 75 did not receive potassium supplementation), and 117 patients who developed hypokalemia after L-AMB initiation (79 received potassium supplementation [including 23 adequate and 15 inadequate supplementation] and 38 did not receive potassium supplementation). The occurrence of any stage of AKI was similar between patients with hypokalemia, regardless of potassium supplementation (i.e., before L-AMB treatment initiation [supplementation, 51%; non-supplementation, 45%; P = 0.570] or after L-AMB initiation [supplementation, 28%; non-supplementation, 32%; P = 0.671]). After adjusting for confounding factors, we found that the occurrence of any stage of AKI was not associated with potassium supplementation before L-AMB initiation (odds ratio [OR]: 1.291, 95% confidence interval [CI]: 0.584–2.852, P = 0.528) or after L-AMB initiation (OR: 0.954, 95% CI: 0.400–2.275, P = 0.915). The occurrence of any stage of AKI tended to decline in patients with hypokalemia who were adequately supplemented with potassium (44%) before, but not after, L-AMB initiation relative to that in patients inadequately supplemented with potassium (61%), however this result was not significant (P = 0.358). Conclusion Potassium supplementation was not associated with any stage of AKI in patients with hypokalemia who were administered L-AMB.

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Analysis of Hypokalemia as a Side Effect of Liposomal Amphotericin in Pediatric Patients

Kobayashi

Keino

Hori

et al. 2018

Pediatric Infectious Disease Journal

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Risk Factors Contributing to Occurrence of Hypokalemia after Liposomal-Amphotericin B Administration

Cited by 3 publications

References 6 publications

Evaluation of hypokalemia and potassium supplementation during administration of liposomal-amphotericin B

Evaluation of hypokalemia and potassium supplementation during administration of liposomal-amphotericin B

Association between potassium supplementation and the occurrence of acute kidney injury in patients with hypokalemia administered liposomal amphotericin B: a nationwide observational study

Analysis of Hypokalemia as a Side Effect of Liposomal Amphotericin in Pediatric Patients

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