P0634RISK OF HYDROELECTROLYTIC AND ACID-BASE DISORDERS INDUCED BY LIPOSOMAL AMPHOTERICIN B USE IN VISCERAL LEISHMANIASIS PATIENTS

Background and Aims

Visceral leishmaniasis (VL) is a serious illness if untreated. Liposomal Amphotericin B (L-AMB) is the more effectiveness treatment against LV and less nephrotoxic formulation. We aim to evaluate expression of kidney transporters in VL patients before and during L-AMB use.

Method

This is a prospective study with 9 selected VL patients that used only L-AMB during hospital stay. Renal transporter analyzes were from before and during the treatment and compared with a control group composed by healthy people. The urine transporters (AQP2, aquaporin 2; NKCC2, Na-K-2Cl cotransporter; NHE3, Na/H exchanger) and a constitutive exosome marker (TSG 101) expressions were measured after urinary exosomes isolation.

Results

No significant increase of TSG 101 was observed in all comparisons, including between both times and vs healthy controls. Additionally, were observed increased urinary protein expression in VL patients in both times (before and after L-AMB use) in comparison with healthy controls of the AQP2: (105.32 (22.90 – 140.27) vs 1362.97 (627.93-2620.09) or 846,20(552.60-1249.14) %, p<0.01); NHE3: (74.81 (57.17 – 126.33) vs 3373.36 (282.69-6877.97) or 462.67 (123.80-7280.21) %, p<0.01); and NKCC2: (90.98 (79.07 – 120.30) vs 634.45 (345.18-1588.41) or 545.74 (284.34-2183.87) %, p=0.03). Moreover, the patients treated with L-AMB showed a significant decrease in AQT2 (P=0.023) and NHE3 (P=0.008) expression.

Conclusion

We suggest that despite less nephrotoxic, the L-AMB use may be monitored to investigate patients at risk of hydroelectrolytic and acid-base disorders.