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Onco-Hypertension in Patients with Kidney Disease
Shubhi Pandey1, Simon Kashfi2, Susana Hong2
1Department of Internal Medicine, Calhoun Cardiology Center, University of Connecticut Health, Farmington, Connecticut, USA.
American Journal of Nephrology
|March 17, 2024
Summary
Antineoplastic medications can cause hypertension and kidney disease. Monitoring blood pressure and kidney function is crucial for managing cancer patients undergoing treatment.
Area of Science:
- Oncology
- Nephrology
- Cardiology
Background:
- Cancer, hypertension, and kidney disease are interconnected.
- Understanding the renal and hypertensive effects of cancer drugs is vital for treatment continuity.
Purpose of the Study:
- To review the literature on antineoplastic medications' effects on blood pressure and kidney function.
- To propose a management strategy for cancer patients with concurrent hypertension and kidney disease.
Main Methods:
- Literature review of antineoplastic agents' effects on cardiovascular and renal systems.
- Analysis of mechanisms linking antineoplastic therapy to hypertension and kidney injury.
- Development of a step-by-step management approach.
Main Results:
- Antineoplastic drugs can induce hypertension, proteinuria, and kidney injury.
- Vascular endothelial growth factor pathway inhibitors show a strong association with hypertension and proteinuria.
- These effects are often acute and reversible upon drug discontinuation.
Conclusions:
- Close monitoring of blood pressure and renal function is essential during cancer treatment.
- Management includes drug cessation in cases of hypertensive crisis or significant kidney injury.
- Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers are preferred for managing hypertension in patients with chronic kidney disease and cancer therapy-related hypertension.
- Multidisciplinary collaboration is key for optimal patient outcomes.
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