Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India
Abstract
Invasive fungal infections are a major challenge in the management of
immunocompromised patients and those with renal dysfunction. These
challenges are due to the immense morbidity and mortality in such
situations. Also the management strategies for invasive mycosis in
patients with renal dysfunction have narrow safety profile and involve
high-cost. In this review we will discuss the issues involved in the
management of invasive mycosis in the patients with renal dysfunction
in the form of acute renal failure, chronic kidney disease, dialysis
dependency of renal transplant recipients. We also emphasize that the
use of Intravenous Liposomal Amphoterecin appears to be an effective
alternative to the conventional Amphoterecin B for the treatment of
invasive fungal infections in patients with renal dysfunction due to
its greatly improved tolerability profile. Commercially two true
liposomal preparations (Fungisome and Ambisome) are available.
Judgement about the preferred formulation should be made on the basis
of disease morbidity, severity of renal dysfunction and the cost
involved