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Nephrotoxicity from chemotherapeutic agents: clinical manifestations, pathobiology, and prevention/therapy

Mark A Perazella1, Gilbert W Moeckel

  • 1Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA. mark.perazella@yale.edu

Seminars in Nephrology
|December 15, 2010
PubMed

Insights

Chemotherapy can harm the kidneys, causing various injuries like acute kidney injury. Understanding these risks and patient factors helps prevent and treat chemotherapy-induced nephrotoxicity.

Area of Science:

  • Nephrology
  • Oncology
  • Pharmacology

Background:

  • Chemotherapeutic agents are essential in cancer treatment but can cause significant kidney damage (nephrotoxicity).
  • Kidney lesions from chemotherapy range from tubular dysfunction to acute and chronic kidney injury.
  • Both the inherent toxicity of drugs and host factors influence the risk of nephrotoxicity.

Purpose of the Study:

  • To review classic nephrotoxic chemotherapeutic agents.
  • To describe the clinical and histopathologic kidney lesions caused by these agents.
  • To discuss preventive and therapeutic strategies for drug-induced nephrotoxicity.

Main Methods:

  • Literature review of established nephrotoxic chemotherapeutic agents.
  • Analysis of clinical presentations and histopathologic findings of kidney damage.
  • Synthesis of current knowledge on prevention and treatment strategies.

Main Results:

  • Identified key chemotherapeutic agents associated with nephrotoxicity.
  • Detailed the spectrum of kidney lesions, including tubular, glomerular, acute, and chronic injury.
  • Highlighted the role of host factors and drug metabolism in nephrotoxicity.

Conclusions:

  • Chemotherapy-induced nephrotoxicity is a serious complication with diverse renal manifestations.
  • Understanding drug mechanisms, patient risk factors, and renal handling is crucial.
  • Proactive measures are necessary for preventing and managing kidney damage during chemotherapy.

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