Sacanella, IgnasiEsteve-Pitarch, ErikaGuevara-Chaux, JessicaBerrueta, JulenGarcía-Martínez, AlejandroGómez, JosepCasarino, CeciliaAlés, FlorenciaCanadell, LauraMartin-Loeches, IgnacioGrau Cerrato, SantiagoCandel, Francisco JavierBodí, MaríaRodriguez Oviedo, Alejandro2025-09-302025-09-302024Sacanella I, Esteve-Pitarch E, Guevara-Chaux J, Berrueta J, García-Martínez A, Gómez J, et al. A real-world data observational analysis of the impact of liposomal amphotericin B on renal function using machine learning in critically ill patients. Antibiotics (Basel). 2024 Aug 12;13(8):760. DOI: 10.3390/antibiotics130807602079-6382http://hdl.handle.net/10230/71318Background: Liposomal amphotericin B (L-AmB) has become the mainstay of treatment for severe invasive fungal infections. However, the potential for renal toxicity must be considered. Aims: To evaluate the incidence of acute kidney injury (AKI) in critically ill patients receiving L-AmB for more than 48 h. Methods: Retrospective, observational, single-center study. Clinical, demographic and laboratory variables were obtained automatically from the electronic medical record. AKI incidence was analyzed in the entire population and in patients with a "low" or "high" risk of AKI based on their creatinine levels at the outset of the study. Factors associated with the development of AKI were studied using random forest models. Results: Finally, 67 patients with a median age of 61 (53-71) years, 67% male, a median SOFA of 4 (3-6.5) and a crude mortality of 34.3% were included. No variations in serum creatinine were observed during the observation period, except for a decrease in the high-risk subgroup. A total of 26.8% (total population), 25% (low risk) and 13% (high risk) of patients developed AKI. Norepinephrine, the SOFA score, furosemide (general model), potassium, C-reactive protein and procalcitonin (low-risk subgroup) were the variables identified by the random forest models as important contributing factors to the development of AKI other than L-AmB administration. Conclusions: The development of AKI is multifactorial and the administration of L-AmB appears to be safe in this group of patients.application/pdfeng© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).info:eu-repo/semantics/articlehttp://dx.doi.org/10.3390/antibiotics13080760Acute kidney injuryAntifungal agentsCritical careLiposomal amphotericin BMachine learningRandom forestinfo:eu-repo/semantics/openAccess