Question

Which of these is NOT caused by amphotericin B?

• A. Azotemia
• B. Glomerulonephritis
• C. Hypokalemia
• D. Renal tubular acidosis

Hint:

Amphotericin B damages renal tubules, not the glomerulus.

Answer 1

The Correct Option is B

Step 1: Recall how amphotericin B damages the kidney.
Amphotericin B binds to cholesterol in cell membranes. This is how it kills fungal cells, but it also binds cholesterol in human kidney tubular cell membranes and damages them, since these membranes are not fully protected from the drug.

Step 2: List the effects of this tubular damage.
Because the injury is at the tubule, not the glomerulus, it produces a reduced GFR with a rise in blood urea and creatinine (azotemia), potassium wasting in the urine leading to hypokalemia, and distal renal tubular acidosis (type 1 RTA) because the tubule cannot secrete hydrogen ions properly.

Step 3: Check each option against this list.
Azotemia is a known effect, since renal blood flow falls and GFR drops with amphotericin B use.
Hypokalemia is a known and common effect, often needing potassium supplements during treatment.
Renal tubular acidosis is a known effect, from direct tubular cell injury.
Glomerulonephritis is an inflammatory disease of the glomerulus, usually immune mediated. Amphotericin B does not target the glomerulus and does not cause this kind of immune injury.

Step 4: Conclude.
Since amphotericin B is a tubular toxin and not a cause of glomerular inflammation, the effect that is NOT caused by it is glomerulonephritis.

Final Answer:
\[ \boxed{\text{Glomerulonephritis}} \]