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Renal toxicities of antineoplastic drugs and bone marrow transplantation
1Division of Nephrology and Hypertension, The Graduate Hospital, Philadelphia, PA 19146, USA.
Abstract:
A number of antineoplastic chemotherapeutic drugs may produce fluid and electrolyte disturbances or nephrotoxic reactions extending across the clinical spectrum, from subclinical renal dysfunction to progressive chronic renal insufficiency to severe acute failure. Although some of the drugs that are highly nephrotoxic are now seldom used, others are tremendously useful in modern clinical oncology. Some newer antineoplastic therapies such as interleukin-2 and bone marrow transplantation are commonly associated with nephrotoxicity. Although our understanding of the pathophysiological mechanisms underlying these toxic reactions is still rather rudimentary, information derived from animal models, coupled with clinical experience, has in many circumstances generated clinical interventions that can successfully limit treatment-related renal injury.
Insights
Certain chemotherapy drugs and newer cancer therapies can cause kidney damage, ranging from mild dysfunction to severe failure. Understanding these risks allows for interventions to limit treatment-related renal injury.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Antineoplastic chemotherapeutic drugs can cause significant fluid and electrolyte disturbances.
- Nephrotoxic reactions range from subclinical renal dysfunction to acute renal failure.
- Newer therapies like interleukin-2 and bone marrow transplantation are associated with nephrotoxicity.
Purpose of the Study:
- To review the spectrum of drug-induced nephrotoxicity in cancer patients.
- To highlight the risks associated with both traditional chemotherapeutics and novel antineoplastic agents.
- To discuss current understanding and management of treatment-related renal injury.
Main Methods:
- Review of clinical literature on chemotherapy-induced nephrotoxicity.
- Analysis of case studies and experimental data on renal adverse effects.
- Synthesis of information on pathophysiological mechanisms and clinical interventions.
Main Results:
- While highly nephrotoxic drugs are used less, many useful chemotherapeutics still pose renal risks.
- Interleukin-2 and bone marrow transplantation are recognized causes of nephrotoxicity.
- Clinical interventions, informed by animal models and experience, can mitigate renal injury.
Conclusions:
- Cancer therapies pose a significant risk of nephrotoxicity.
- Despite rudimentary understanding of mechanisms, effective interventions exist.
- Managing renal complications is crucial for successful cancer treatment.