Liposomal-Amphotericin B (L-AMB) may cause hypokalemia. This study was carried out to examine the occurrence of hypokalemia and its primary causes in 74 patients who were administered L-AMB. They were divided into 2 groups regarding the severity of hypokalemia that occurred: Grade 0-2 group: 35 patients (47.3%), and Grade 3-4 group: 39 patients (52.7%). The results of a comparison of the Grade 0-2 group and Grade 3-4 group showed that causes for the Grade 3-4 group were significantly different from those in the Grade 0-2 group, which were a serum albumin level of more than 2.82 mg/dL at the start of the L-AMB administration (p=0.004, OR: 8.711, 95%CI: 2.273-45.823), and a history of hypokalemia before L-AMB administration (p=0.009, OR: 7.859, 95%CI: 1.844-44.109) in the Grade 3-4 group.
While combination with trimethoprim-sulfamethoxazole resulted in significant avoidance of Grade 3-4 hypokalemia (p=0.019, OR: 0.233, 95%CI: 0.063-0.750), administration of potassium for preventive or maintenance purposes did not affect the occurrence of hypokalemia (p=0.137, p=0.198). However, for 20 patients with an abnormal serum potassium level (Grade 1 and more) at the start of L-AMB administration, our findings suggested that the preventive/maintenance administration of potassium was indeed effective (p=0.011).
It has been proven that L-AMB causes hypokalemia frequently and the primary causes have been clarified. In this regard, it is important to regularly monitor serum potassium levels and adjust them depending on the situation of patients with hypokalemia.
