Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Renal Failure: Dose Adjustments01:11

Renal 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...
Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions01:09

Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions

Renal clearance plays a pivotal role in drug elimination from the body and can be influenced by drug distribution and interactions. Understanding these factors is crucial in pharmacology as they impact the effectiveness and duration of drug therapy.
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
Renal Drug Excretion: Tubular Secretion01:28

Renal Drug Excretion: Tubular Secretion

Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
Renal Drug Excretion: Overview01:15

Renal Drug Excretion: Overview

As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules out...
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug 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...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Establishing a core outcome measure for cancer in trials in kidney transplantation: a standardized outcomes in nephrology-kidney transplantation consensus workshop report.

Transplant international : official journal of the European Society for Organ Transplantation·2026
Same author

AKI After Hepatic Histotripsy.

Kidney international reports·2026
Same author

Phosphate Disorders in Cancer.

Kidney360·2026
Same author

Enteric and Controlled-Release Budesonide in IgA Nephropathy: Expanding Access While Refining Evidence.

Kidney international reports·2026
Same author

Post Kidney Transplant Thrombotic Microangiopathy: A Narrative Review of the Challenges and Opportunities.

Kidney360·2026
Same author

When the Podocyte Speaks First: Anti-Nephrin Associated Diffuse Podocytopathy Preceding Hodgkin's Lymphoma.

Kidney360·2026

Related Experiment Video

Updated: May 7, 2026

Identification of the Source of Secreted Proteins in the Kidney by Brefeldin A Injection
10:15

Identification of the Source of Secreted Proteins in the Kidney by Brefeldin A Injection

Published on: November 10, 2021

Clofarabine-induced kidney toxicity.

Kenar D Jhaveri1, Shailaja Chidella2, Steven L Allen3

  • 1Division of Nephrology, Hofstra North Shore LIJ School of Medicine, Great Neck, NY, USA kdj200@gmail.com.

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
|October 2, 2013
PubMed
Summary
This summary is machine-generated.

Clofarabine, a leukemia treatment, can cause acute kidney injury in adults. This case study and literature review suggest potential mechanisms like collapsing glomerulopathy or tubular injury.

Keywords:
Clofarabineacute renal failureproteinuriarenal toxicity

More Related Videos

Acute Kidney Injury Model Induced by Cisplatin in Adult Zebrafish
13:25

Acute Kidney Injury Model Induced by Cisplatin in Adult Zebrafish

Published on: May 15, 2021

Related Experiment Videos

Last Updated: May 7, 2026

Identification of the Source of Secreted Proteins in the Kidney by Brefeldin A Injection
10:15

Identification of the Source of Secreted Proteins in the Kidney by Brefeldin A Injection

Published on: November 10, 2021

Acute Kidney Injury Model Induced by Cisplatin in Adult Zebrafish
13:25

Acute Kidney Injury Model Induced by Cisplatin in Adult Zebrafish

Published on: May 15, 2021

Area of Science:

  • Oncology
  • Nephrology
  • Pharmacology

Background:

  • Clofarabine is a purine nucleoside analog used for pediatric acute lymphoblastic leukemia.
  • It is increasingly used off-label for relapsed/refractory acute myeloid leukemia in adults.
  • Clofarabine inhibits DNA synthesis and ribonucleotide reductase.

Observation:

  • A 48-year-old male with refractory acute myeloid leukemia developed acute kidney injury during clofarabine treatment.
  • A review of literature and FDA Adverse Event Reporting System identified 29 additional cases of renal adverse events associated with clofarabine.
  • The observed cases involved severe acute kidney injury and proteinuria.

Findings:

  • Clofarabine's mechanism involves inhibiting ribonucleotide reductase.
  • Animal studies suggest potential mechanisms for kidney injury include collapsing glomerulopathy or severe tubular injury.
  • These mechanisms are consistent with human observations of severe acute kidney injury and proteinuria.

Implications:

  • Clofarabine may pose a risk of significant renal toxicity in adult patients with acute myeloid leukemia.
  • Further investigation into the nephrotoxic mechanisms of clofarabine is warranted.
  • Clinicians should monitor renal function closely in patients receiving clofarabine, especially for off-label indications.