Urinary acidification after ammonium chloride loading was evaluated in 22 patients treated with amphotericin B and in ten normal volunteers. Six patients were studied while receiving amphotericin B; all had defective renal excretion of acid, although systemic acidosis was absent. Four of these patients were restudied following treatment; three were normal at two, four, and eight months respectively; and one remained abnormal at ten months. Three patients, initially studied one to five months after completion of treatment, excreted an acid load normally. Fourteen patients studied more than a year following treatment with amphotericin B were all normal. Incomplete renal tubular acidosis is a common, but reversible, complication of amphotericin B therapy. Urinary acidification is normal within a few months after treatment is discontinued. Alkali therapy is indicated in patients who develop renal tubular acidosis and potassium supplementation should be given if hypokalemia appears.
Patterson RM, Ackerman GL. Renal Tubular Acidosis Due to Amphotericin B Nephrotoxicity. Arch Intern Med. 1971;127(2):241-244. doi:10.1001/archinte.1971.00310140069007