Which side effect is often associated with high doses of amphotericin B?

Amphotericin B is a polyene antifungal agent primarily used to treat severe fungal infections. While it is effective in addressing a wide range of mycoses, it is notorious for its potential side effects, particularly nephrotoxicity, especially at high doses.

The mechanism behind this side effect involves the drug's interaction with cholesterol in cell membranes, which can lead to renal vasoconstriction and damage to the renal tubular cells, ultimately resulting in a decline in kidney function. Nephrotoxicity can manifest as elevated serum creatinine levels, decreased urine output, and electrolyte imbalances. This side effect is a significant concern when administering amphotericin B, necessitating careful monitoring of kidney function during treatment and sometimes pre-treatment with hydration or the use of lipid formulations of the drug to reduce toxicity.

While other options listed may be potential concerns in different contexts or with other medications, nephrotoxicity is particularly well-documented as a primary concern associated with high doses of amphotericin B, making it the correct choice for this question.