Related Experiment Video
Updated: Jun 10, 2026
05:34
5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
Published on: April 4, 2025
Kidney dysfunction during lenalidomide treatment for AL amyloidosis
Richard Specter1, Vaishali Sanchorawala, David C Seldin
1Renal Section, Boston University School of Medicine, Boston, MA, USA.
Summary
Lenalidomide treatment frequently causes kidney dysfunction in AL amyloidosis patients. Close monitoring of renal function is recommended during therapy.
Area of Science:
- Nephrology
- Hematology
- Pharmacology
Background:
- Lenalidomide is an immunomodulatory drug for plasma cell dyscrasias.
- Previous observations indicated significant kidney function decline in AL amyloidosis patients on lenalidomide.
- This study aims to detail kidney function changes in AL amyloidosis patients receiving lenalidomide.
Purpose of the Study:
- To characterize kidney function alterations in AL amyloidosis patients during lenalidomide treatment.
Main Methods:
- Secondary analysis of a clinical trial involving 41 AL amyloidosis patients treated with lenalidomide.
- Kidney dysfunction defined as >= 50% serum creatinine increase; severe dysfunction as >= 100% increase.
- Renal function recovery defined as serum creatinine returning to within 25% of baseline or dialysis discontinuation.
Main Results:
- 66% of patients (27/41) developed kidney dysfunction.
- Severe kidney dysfunction occurred in 32% (13/41), with 10% (4/41) requiring dialysis.
- Factors associated with severe dysfunction included older age, renal amyloidosis, higher proteinuria, and lower albumin.
Conclusions:
- Worsening kidney function is common in AL amyloidosis patients treated with lenalidomide.
- While causality is unproven, the findings highlight the need for vigilant kidney function monitoring.
- Close surveillance of renal function is advised for patients undergoing lenalidomide therapy.
Related Concept Videos
01:11Renal Failure: Dose Adjustments
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:24Chronic Kidney Disease II: Clinical Manifestations
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
01:28Chronic Kidney Disease III: Interprofessional Care
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
01:18Chronic Kidney Disease IV: Nursing Management
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...