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Related Concept Videos

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

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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...
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Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

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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...
547
Renal Drug Excretion: Tubular Reabsorption01:25

Renal Drug Excretion: Tubular Reabsorption

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Tubular reabsorption, a process occurring post-glomerular filtration of drugs in the renal tubule, is a critical determinant of drug half-life. During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. This...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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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...
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Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

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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...
534
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Related Experiment Video

Updated: Mar 6, 2026

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin
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[Renal Disorders and Drug Therapy].

Satoru Muto1

  • 1Dept. of Urology, Teikyo University School of Medicine.

Gan to Kagaku Ryoho. Cancer & Chemotherapy
|March 16, 2017
PubMed
Summary

Assessing kidney function in cancer patients undergoing chemotherapy is crucial due to rising chronic kidney disease rates. Current methods like serum creatinine and estimated glomerular filtration rate (eGFR) have limitations, necessitating improved diagnostic tools for chemotherapy-induced kidney injury.

Area of Science:

  • Nephrology
  • Oncology
  • Pharmacology

Background:

  • Increasing incidence of chronic kidney disease (CKD) among cancer patients receiving chemotherapy.
  • Nephropathy is a significant adverse event associated with cancer drug therapy.
  • Balancing therapeutic benefits against risks of renal function decline is critical, especially in patients with pre-existing CKD.

Purpose of the Study:

  • To highlight the challenges in assessing renal function during cancer drug therapy.
  • To discuss the limitations of current renal function assessment methods (serum creatinine, eGFR).
  • To emphasize the need for reliable methods for early diagnosis of chemotherapy-induced kidney injury.

Main Methods:

  • Review of current practices for assessing renal function in cancer patients.

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  • Discussion of the utility and limitations of serum creatinine and estimated glomerular filtration rate (eGFR).
  • Consideration of Japanese eGFR recommendations for dose adjustments and clinical trial assessment methods.

    • Main Results:

    • Existing methods for assessing renal function, including serum creatinine and eGFR, are problematic and lack established protocols for use before and after cancer drug therapy.
    • The Japanese eGFR is recommended for assessing renal function when adjusting anticancer drug doses.
    • Biomarker-based assessment for early diagnosis of anticancer drug-induced acute kidney injury (AKI) is not currently recommended.

    Conclusions:

    • There is a critical need for established methods to accurately assess renal function in cancer patients undergoing chemotherapy.
    • Current assessment tools have limitations, impacting safe and effective cancer drug dosing.
    • Further research is required to develop reliable biomarkers for the early detection of chemotherapy-induced AKI.