[Renal complications of anti-cancer treatments]

Life prolongation in cancer patients is attended by a greater frequency of renal lesions associated with chemotherapy, and in the last few years cancer patients cured or in lasting remission have begun to haunt dialysis centres. Before blaming the renal toxicity of cytotoxic drugs, it is necessary to exclude all other causes of renal dysfunction (pre-renal, obstructive, iatrogenic or cancer-related). The renal toxicity of certain drugs, such as cisplatin, cyclophosphamide, ifosfamide, streptozocin, nitrosoureas, methotrexate, mitomycin C and recombinant IL2, is of importance as it is frequent and limits their use. The dangers of anticancerous drugs combinations, concomitant administration of other nephrotoxic drugs (antibiotics, non-steroidal anti-inflammatory agents) and extracellular dehydration created by gastrointestinal disorders must be borne in mind. Careful evaluation of renal function prior to chemotherapy, application of preventive measures with proven efficacy and repeated laboratory tests in short-mid- and long-term should reduce the frequency of renal complications while preserving or even improving therapeutic effectiveness.