Polyuria in a Patient with Aspergillus Infection

Effects of amphotericin B on distal tubule function. In the principal cell, amphotericin can have multiple effects, including increasing cell membrane permeability through the insertion of pores into the membrane that leak potassium into the tubular lumen and lead to hypokalemia. Amphotericin B also inhibits vasopressin-induced insertion of aquaporin 2 (AQP-2) channels into the luminal cell membrane. This leads to the development of concentrating defects and polyuria. In the intercalated cell, amphotericin B also creates pores in the cell membrane, which allow back diffusion of hydrogen ions into the cell with impairment of distal tubular acidification and the development of a nonanion gap acidosis. K+, potassium; Na+, sodium; V2 receptor, vasopressin type 2 receptor.