Nephrotoxicity from chemotherapeutic agents: clinical manifestations, pathobiology, and prevention/therapy

Semin Nephrol. 2010 Nov;30(6):570-81. doi: 10.1016/j.semnephrol.2010.09.005.

Abstract

Nephrotoxicity remains a vexing complication of chemotherapeutic agents. A number of kidney lesions can result from these drugs, including primarily tubular-limited dysfunction, glomerular injury with proteinuria, full-blown acute kidney injury, and long-term chronic kidney injury. In most cases, these kidney lesions develop from innate toxicity of these medications, but underlying host risk factors and the renal handling of these drugs clearly increase the likelihood of nephrotoxicity. This article reviews some of the classic nephrotoxic chemotherapeutic agents and focuses on examples of the clinical and histopathologic kidney lesions they cause as well as measures that may prevent or treat drug-induced nephrotoxicity.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Antineoplastic Agents / adverse effects*
  • Cisplatin / adverse effects
  • Diphosphonates / adverse effects
  • Humans
  • Ifosfamide / adverse effects
  • Kidney Glomerulus / drug effects
  • Kidney Glomerulus / pathology
  • Kidney Glomerulus / physiopathology
  • Kidney Tubules / drug effects
  • Kidney Tubules / pathology
  • Kidney Tubules / physiopathology
  • Methotrexate / adverse effects
  • Pamidronate
  • Renal Insufficiency, Chronic / chemically induced*
  • Risk Factors

Substances

  • Antineoplastic Agents
  • Diphosphonates
  • Pamidronate
  • Cisplatin
  • Ifosfamide
  • Methotrexate