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Review
. 2020 Apr 24;11(4):190-204.
doi: 10.5306/wjco.v11.i4.190.

Nephrotoxicity in cancer treatment: An overview

Maria Luísa Cordeiro Santos  1 , Breno Bittencourt de Brito  1 , Filipe Antônio França da Silva  1 , Anelise Costa Dos Santos Botelho  1 , Fabrício Freire de Melo  2
Affiliations
Review

Nephrotoxicity in cancer treatment: An overview

Maria Luísa Cordeiro Santos et al. World J Clin Oncol. .

Abstract

Anticancer drug nephrotoxicity is an important and increasing adverse drug event that limits the efficacy of cancer treatment. The kidney is an important elimination pathway for many antineoplastic drugs and their metabolites, which occurs by glomerular filtration and tubular secretion. Chemotherapeutic agents, both conventional cytotoxic agents and molecularly targeted agents, can affect any segment of the nephron including its microvasculature, leading to many clinical manifestations such as proteinuria, hypertension, electrolyte disturbances, glomerulopathy, acute and chronic interstitial nephritis, acute kidney injury and at times chronic kidney disease. The clinician should be alert to recognize several factors that may maximize renal dysfunction and contribute to the increased incidence of nephrotoxicity associated with these drugs, such as intravascular volume depletion, the associated use of nonchemotherapeutic nephrotoxic drugs (analgesics, antibiotics, proton pump inhibitors, and bone-targeted therapies), radiographic ionic contrast media or radiation therapy, urinary tract obstruction, and intrinsic renal disease. Identification of patients at higher risk for nephrotoxicity may allow the prevention or at least reduction in the development and severity of this adverse effect. Therefore, the aim of this brief review is to provide currently available evidences on oncologic drug-related nephrotoxicity.

Keywords: Acute kidney injury; Cancer; Chemotherapy; Conventional cytotoxic agents; Molecularly targeted agents; Nephrotoxicity.

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Conflict of interest statement

Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.

Figures

Figure 1
Figure 1
Renal effects of anticancer drugs. AKI: Acute kidney injury; CKD: Chronic kidney disease; SIADH: Syndrome of inappropriate antidiuretic hormone secretion; TMA: Thrombotic microangiopathy.
Figure 2
Figure 2
Kidney injury in cancer patient. AKI: Acute kidney disease.
Figure 3
Figure 3
Chemotherapy-induced nephron specific segment injury. TKI: Tyrosine kinase inhibitors; VEGF: Vascular endothelial growth factor; IL-2: Interleukin-2; INF-a: Interferon-alpha.
See this image and copyright information in PMC

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