Explain Nephrotoxicity

Nephrotoxicity is the major dose-limiting toxicity of amphotericin B deoxycholate; sodium loading with  normal saline may prevent or ameliorate it and is generally recommended for patients who can tolerate a fluid load. The nephrotoxicity of amphotericin B may add to the nephrotoxicity of other drugs including cyclosporine (Sandimmune, Neoral), tacrolimus  (Prograf)  and aminoglycoside antibiotics like gentamicin (Garamycin, and others). Hypo- kalemia and hypomagnesemia are common and are usually due to a mild renal tubular acidosis. Weight loss, malaise, anemia, thrombocytopenia and mild leukopenia can happen. Cardiac toxicity and myopathy have been reported.