Conventional cytotoxic chemotherapy-associated nephrotoxicity: consensus report of the 34th Acute Disease Quality
Mark A Perazella1, Lui Forni2, Paolo Lentini3
1Nephrology Department "St. Bassiano" Hospital, Bassano del Grappa (Vi), Italy; International Renal Research Institute (IRRIV), Vicenza, Italy; Department of Nephrology, University of Verona, Verona, Italy.
Kidney International
|March 25, 2026
Summary
Cytotoxic chemotherapy, used to treat cancer, can cause kidney damage (nephrotoxicity). This review focuses on common chemotherapy drugs and strategies to prevent and manage this adverse effect.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Cancer therapies have advanced, improving survival rates.
- Cytotoxic chemotherapy is a cornerstone of cancer treatment, often combined with other agents.
- Nephrotoxicity is a significant adverse effect of many chemotherapy drugs, leading to acute and chronic kidney injury.
Purpose of the Study:
- To review the nephrotoxicity associated with common cytotoxic chemotherapy agents.
- To cover epidemiology, mechanisms, risk factors, clinical manifestations, and management of chemotherapy-induced kidney injury.
- To identify research gaps in understanding and managing cytotoxic chemotherapy nephrotoxicity.
Main Methods:
- Review of literature on nephrotoxicity of specific cytotoxic agents.
- Analysis of epidemiological data, mechanisms of injury, and clinical presentations.
- Synthesis of current knowledge on prevention, management, and future research directions.
Main Results:
- Cisplatin, ifosfamide, methotrexate, pemetrexed, gemcitabine, melphalan, and mitomycin C are frequently encountered nephrotoxic agents.
- Detailed review of the epidemiology, mechanisms, risk factors, and clinical manifestations for each agent.
- Current strategies for prevention and management of kidney injury are discussed, alongside identified research needs.
Conclusions:
- Cytotoxic chemotherapy poses a significant risk of kidney injury, impacting cancer patient outcomes.
- Understanding the specific nephrotoxic profiles of agents like cisplatin is crucial for clinical practice.
- Further research is needed to optimize the prevention and management of chemotherapy-induced nephrotoxicity.
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