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Liposomal amphotericin B (LAmB) has a significantly improved toxicity profile versus conventional amphotericin B deoxycholate and is recommended for a wide range of medically important opportunistic fungal pathogens. Although rates are significantly lower than with older formulations, nephrotoxicity with LAmB remains a concern. Risk factors for renal toxicity with LAmB include higher doses, longer duration of treatment, concomitant use of nephrotoxic agents and the presence of pre-existing kidney disease. Appropriate patient screening, individualized risk assessment, and patient monitoring may reduce the risk of renal toxicity. The prophylactic use of intravenous saline fluids is also recommended with LAmB to reduce the risk of nephrotoxicity. In addition, magnesium and potassium supplementation should be considered to reduce the risk of hypomagnesaemia and hypokalaemia, respectively. Alternate dosing strategies, including intermittent dosing and, for certain fungal infections, single-dose high-dose induction therapy, may be useful in minimizing nephrotoxicity, but additional research is necessary.<\/jats:p>","DOI":"10.1093\/jac\/dkaf473","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T13:14:08Z","timestamp":1765458848000},"source":"Crossref","is-referenced-by-count":14,"title":["Liposomal amphotericin B and renal safety: review of the evidence and clinical considerations"],"prefix":"10.1093","volume":"81","author":[{"given":"Johan","family":"Maertens","sequence":"first","affiliation":[{"name":"Department of Haematology, University Hospital Leuven , Leuven ,","place":["Belgium"]},{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Birne","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Unidade Local de Sa\u00fade de Lisboa Ocidental , Lisbon ,","place":["Portugal"]},{"name":"NOVA Medical School , Lisbon ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Felton","sequence":"additional","affiliation":[{"name":"Division of Infection, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester , Manchester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionysios","family":"Neofytos","sequence":"additional","affiliation":[{"name":"Transplant Infectious Diseases Unit, Division of Infectious Diseases, University Hospitals of Geneva , Geneva ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hoenigl","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Medical University of Graz , Graz ,","place":["Austria"]},{"name":"Translational Mycology Unit, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"issue":"Suppl 4","key":"2026011902094029400_dkaf473-B1","doi-asserted-by":"publisher","first-page":"S260","DOI":"10.1093\/cid\/ciz076","article-title":"Clinical pharmacokinetics, pharmacodynamics, safety and efficacy of liposomal amphotericin B","volume":"68","author":"Groll","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"Suppl 4","key":"2026011902094029400_dkaf473-B2","doi-asserted-by":"publisher","first-page":"S244","DOI":"10.1093\/cid\/ciz064","article-title":"Preclinical 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