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Doganci M, Zeyneloğlu P, Kayhan Z, Ayhan A. Determination of Risk Factors for Postoperative Acute Kidney Injury in Patients With Gynecologic Malignancies. Cureus 2023; 15:e41836. [PMID: 37575800 PMCID: PMC10423056 DOI: 10.7759/cureus.41836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Background Postoperative acute kidney injury (AKI) is an important cause of mortality and morbidity among surgical patients. There is little information on the occurrence of AKI after operations for gynecologic malignancies. This study aimed to determine the incidence of AKI in patients who underwent surgery for gynecological malignancies and determine the risk factors in those who developed postoperative AKI. Methodology A total of 1,000 patients were enrolled retrospectively from January 2007 to March 2013. AKI was defined according to the Kidney Disease Improving Global Outcomes 2012 Clinical Practice Guideline for Acute Kidney Injury. Perioperative variables of patients were collected from medical charts. Results The incidence of postoperative AKI was 8.8%, with stage 1 occurring in 5.9%, stage 2 in 2.4%, and stage 3 in 0.5% of the patients. Patients who had AKI were significantly older, had higher body mass index (BMI) higher preoperative C-reactive protein (CRP) levels, and more frequently had a history of distant organ metastasis when compared with those who did not have AKI. When compared with patients who did not develop AKI postoperatively, longer operation times and intraoperative usage of higher amounts of erythrocyte suspension and fresh frozen plasma were seen in those who developed AKI. Conclusions Patients who had AKI were older, had higher BMI with higher preoperative CRP levels, more frequent distant organ metastasis, longer operation times, and higher amounts of blood transfused intraoperatively. Defining preoperative, intraoperative, and postoperative risk factors for postoperative AKI and taking necessary precautions are important for the early detection and intervention of AKI.
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Affiliation(s)
- Melek Doganci
- Department of Critical Care, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, TUR
| | - Pınar Zeyneloğlu
- Department of Anesthesiology and Intensive Care Unit, Başkent University Faculty of Medicine, Ankara, TUR
| | - Zeynep Kayhan
- Department of Anesthesiology and Reanimation, Başkent University Faculty of Medicine, Ankara, TUR
| | - Ali Ayhan
- Department of Obstetrics and Gynecology, Başkent University Faculty of Medicine, Ankara, TUR
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Su YQ, Yu YY, Shen B, Yang F, Nie YX. Management of acute kidney injury in gastrointestinal tumor: An overview. World J Clin Cases 2021; 9:10746-10764. [PMID: 35047588 PMCID: PMC8678862 DOI: 10.12998/wjcc.v9.i35.10746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/08/2021] [Accepted: 09/06/2021] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal tumors remain a global health problem. Acute kidney injury (AKI) is a common complication during the treatment of gastrointestinal tumors. AKI can cause a decrease in the remission rate and an increase in mortality. In this review, we analyzed the causes and risk factors for AKI in gastrointestinal tumor patients. The possible mechanisms of AKI were divided into three groups: pretreatment, intrafraction and post-treatment causes. Treatment and prevention measures were proposed according to various factors to provide guidance to clinicians and oncologists that can reduce the incidence of AKI and improve the quality of life and survival rate of gastrointestinal tumor patients.
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Affiliation(s)
- Yi-Qi Su
- Department of Nephrology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen 361015, Fujian Province, China
| | - Yi-Yi Yu
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Bo Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Feng Yang
- Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Yu-Xin Nie
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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3
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Krieg S, Seeger H, Hofmann P, Del Prete C, Manz MG, Müller AM, Theocharides APA. Baseline creatinine predicts acute kidney injury during intensive therapy in transplant-eligible patients with acute myeloid leukaemia. Br J Haematol 2021; 196:781-784. [PMID: 34611894 DOI: 10.1111/bjh.17854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Stefan Krieg
- Department of Medical Oncology and Haematology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Harald Seeger
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | - Patrick Hofmann
- Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Carmen Del Prete
- Department of Medical Oncology and Haematology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Markus G Manz
- Department of Medical Oncology and Haematology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Antonia M Müller
- Department of Medical Oncology and Haematology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Alexandre P A Theocharides
- Department of Medical Oncology and Haematology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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4
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Peña Zavala R, Marzouki M, Beaunoyer M, Alvarez F. Glomerular filtration rate in liver transplant for unresectable hepatoblastoma. Pediatr Transplant 2020; 24:e13746. [PMID: 32459045 DOI: 10.1111/petr.13746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 04/26/2020] [Accepted: 05/01/2020] [Indexed: 01/29/2023]
Abstract
Most children with hepatoblastoma manifest, at the time of LT, a decrease in renal function due to chemotherapy that could be further deteriorated by the use of calcineurin inhibitors. The purpose of this work was to examine the long-term follow-up of renal function in a cohort of children transplanted for unresectable hepatoblastoma. We present a retrospective observational study of 10 pediatric patients who received a LT for unresectable hepatoblastoma between 1996 and 2016. All patients included in this study were followed up on a regular basis and were assessed for GFR before transplantation and at least once a year during follow-up. All patients received standardized chemotherapy treatment for hepatoblastoma and immunosuppression according to hospital protocols. There was a marked decrease in GFR at the time of the LT in five patients presenting renal complications during the pretransplant cycles of chemotherapy. Three patients, one of them with prior kidney involvement, presented complications after LT, namely acute kidney failure and decrease in GFR. Those patients who presented with the lowest GFR at the time of LT eventually recovered renal function at levels similar to the rest of the group on follow-up. Chemotherapy-induced nephrotoxicity is a concern in patients treated for hepatoblastoma. Some individuals will develop low GFR after chemotherapy; therefore, strict follow-up is recommended, as low GFR may affect the doses of subsequent chemotherapy and immunosuppression. Stabilization of GFR levels and occasional improvement can be observed in the post-transplant period.
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Affiliation(s)
- Ruben Peña Zavala
- Department of Pediatrics, Faculty of Medicine, University of Concepcion, Concepcion, Chile
| | - Mounia Marzouki
- Division of Hematology-Oncology, Department of Pediatrics, Saint Justine Hospital, Montreal, QC, Canada
| | - Mona Beaunoyer
- Department of Surgery, Saint Justine Hospital, Montreal, QC, Canada
| | - Fernando Alvarez
- Division of Gastroenterology and Nutrition, Department of Pediatrics, Saint Justine Hospital, Montreal, QC, Canada
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5
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Guler E, Col N, Buyukcelik M, Balat A. Prevalence of hypertension determined by ambulatory blood pressure monitoring (ABPM) and body composition in long-term survivors of childhood cancer. Pediatr Hematol Oncol 2018. [PMID: 29528260 DOI: 10.1080/08880018.2018.1425784] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
AIM In recent years, survival rates of childhood cancers have significantly increased, and occurrence of long-term adverse late effects (eg, insulin resistance, diabetes mellitus, metabolic syndrome, hypertension) has become increasingly important. Early diagnosis of obesity/hypertension in childhood is essential to avoid morbidity in the adulthood. Therefore, this study was aimed to determine the blood pressure (BP) profile by ambulatory BP monitoring (ABPM) method, and prevalence of hypertension, obesity, abdominal obesity among childhood cancer survivors. MATERIAL AND METHOD The study was carried out with 52 cancer survivors. The ABPM measurement was performed during 24 hours. The anthropometric measurements of patients were performed using standardized protocols. The body composition analysis was performed with bioelectrical impedance analysis (BIA) method. Statistical significance was considered at p < 0.05. RESULTS The mean age of patients was 12.84 ± 3.88 years. Time off therapy ranged 24-125 month. The prevalence of prehypertension and hypertension were 57.7% and 9.6%, respectively. There was no statistically significant relationship between diagnosis and BP status (p = 0.59). The prevalence of obesity, and abdominal obesity were 1.9% and 30.4%, respectively. There was a positive correlation between waist circumference (WC) and time off therapy (p = 0.046). The WC was found to be higher in patients who received cranial irradiation (p = 0.048). Weight/WC were higher in patients who used corticosteroids in the treatment (p = 0.019). CONCLUSION Careful follow up of BP, weight and WC is necessary for long-term cancer survivors to prevent complications. Especially patients who receive cranial radiotherapy and use corticosteroid are at increased risk of abdominal obesity.
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Affiliation(s)
- Elif Guler
- a Department of Pediatric Hematology Oncology, Faculty of Medicine , University of Akdeniz , Antalya , Turkey
| | - Nilgun Col
- b Department of Social Pediatrics , Faculty of Medicine, University of Gaziantep , Gaziantep , Turkey
| | - Mithat Buyukcelik
- c Department of Pediatric Nephrology , Faculty of Medicine, University of Gaziantep , Gaziantep , Turkey
| | - Ayse Balat
- d Department of Pediatric Nephrology , Faculty of Medicine, University of İstanbul Aydın , İstanbul , Turkey
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6
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Sharbaf FG, Farhangi H, Assadi F. Prevention of Chemotherapy-Induced Nephrotoxicity in Children with Cancer. Int J Prev Med 2017; 8:76. [PMID: 29114374 PMCID: PMC5651649 DOI: 10.4103/ijpvm.ijpvm_40_17] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 08/20/2017] [Indexed: 01/14/2023] Open
Abstract
Children with cancer treated with cytotoxic drugs are frequently at risk of developing renal dysfunction. The cytotoxic drugs that are widely used for cancer treatment in children are cisplatin (CPL), ifosfamide (IFO), carboplatin, and methotrexate (MTX). Mechanisms of anticancer drug-induced renal disorders are different and include acute kidney injury (AKI), tubulointerstitial disease, vascular damage, hemolytic uremic syndrome (HUS), and intrarenal obstruction. CPL nephrotoxicity is dose-related and is often demonstrated with hypomagnesemia, hypokalemia, and impaired renal function with rising serum creatinine and blood urea nitrogen levels. CPL, mitomycin C, and gemcitabine treatment cause vascular injury and HUS. High-dose IFO, streptozocin, and azacitidine cause renal tubular dysfunction manifested by Fanconi syndrome, rickets, and osteomalacia. AKI is a common adverse effect of MTX, interferon-alpha, and nitrosourea compound treatment. These strategies to reduce the cytotoxic drug-induced nephrotoxicity should include adequate hydration, forced diuresis, and urinary alkalization. Amifostine, sodium thiosulfate, and diethyldithiocarbamate provide protection against CPL-induced renal toxicity.
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Affiliation(s)
- Fatemeh Ghane Sharbaf
- Department of Pediatric, Division of Nephrology, Dr. Sheikh Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Farhangi
- Department of Pediatrics, Division of Hematology and Oncology, Dr. Sheikh Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farahnak Assadi
- Department of Pediatrics, Division of Nephrology, Rush University Medical Center, Chicago, Illinois, USA
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7
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Małyszko J, Kozlowski L, Kozłowska K, Małyszko M, Małyszko J. Cancer and the kidney: dangereoux liasons or price paid for the progress in medicine? Oncotarget 2017; 8:66601-66619. [PMID: 29029541 PMCID: PMC5630441 DOI: 10.18632/oncotarget.18094] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 04/23/2017] [Indexed: 01/10/2023] Open
Abstract
A long time ago, the links between renal disease and malignancy were observed, however, quite recently, their importance was recognized and 'new' subspecialty in nephrology, namely 'onconephrology' was established. In the XXI century, patients with malignancy make up the most growing number of the subjects seen for nephrology consult and/or critical care nephrology services. A plethora of renal problems may be found in patients with malignancy. They may influence not only their short-term outcomes but also the adequate therapy of the underlying oncological problem. Thus, all these kidney-related issues pose an important challenge for both specialities: oncology and nephrology. In the review a spectrum of acute and chronic renal injury caused by the malignancy is presented as well as the associations between renal disease and cancer. Assessment of kidney function and its importance in patients with malignancy is also discussed as medical oncologists should check the appropriate dose of chemotherapeutic drugs in relation to the actual renal function before prescribing them to the patients. Moreover, effects of kidney function on outcomes in oncology is presented. In addition, nephrology services should better understand both the biology of malignancy with its treatment to become a valuable part treating team to yield the best possible outcome. It is important for nephrology services to be acknowledged and to take an active participation in care of oncology patients.
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Affiliation(s)
- Jolanta Małyszko
- Second Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, Bialystok, Poland
| | - Leszek Kozlowski
- Department of Oncological Surgery, Ministry of Interior Affairs, Bialystok, Poland
| | - Klaudia Kozłowska
- Second Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, Bialystok, Poland
| | - Maciej Małyszko
- Second Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, Bialystok, Poland
| | - Jacek Małyszko
- First Department of Nephrology and Transplantology with Dialysis Unit, Medical University of Bialystok, Bialystok, Poland
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8
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Gunn HM, Emilsson H, Gabriel M, Maguire AM, Steinbeck KS. Metabolic Health in Childhood Cancer Survivors: A Longitudinal Study in a Long-Term Follow-Up Clinic. J Adolesc Young Adult Oncol 2015; 5:24-30. [PMID: 26812459 DOI: 10.1089/jayao.2015.0036] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Childhood cancer survivors (CCS) are at increased risk of metabolic dysfunction as a late effect of cancer treatment. However, pediatric metabolic syndrome (MetS) lacks a unified definition, limiting the diagnosis of MetS in CCS. This study evaluated individual metabolic health risk factors and potential areas for intervention in this at-risk population. METHODS This single center, retrospective observational longitudinal study evaluated the metabolic health of all CCS attending an oncology long-term follow-up clinic at a university hospital in Sydney, Australia (January 2012-August 2014). Participants were 276 CCS (52.2% male; mean age 18.0 years; range 6.8-37.9 years), at least 5 years disease free with a broad spectrum of oncological diagnoses. Primary metabolic health risk factors included raised body mass index, hypertension, and hypertransaminasemia. Participants treated with cranial radiotherapy (n = 47; 17.0% of cohort) had additional biochemical variables analyzed: fasting glucose/insulin, HDL/LDL cholesterol, and triglycerides. RESULTS Hypertension was common (19.0%), with male sex (p < 0.01) and being aged 18 years or above (p < 0.01) identified as risk factors. Cranial irradiation was a risk factor for overweight/obesity (47.8% in cranial radiotherapy-treated participants vs. 30.4%; p = 0.02). Hypertransaminasemia was more prevalent among participants treated with radiotherapy (15.6% vs. 7.3%; p = 0.03), and overweight/obese participants (17.6% vs. 8.2%; p = 0.04). CONCLUSION Metabolic health risk factors comprising MetS are common in CCS, placing this population at risk of premature adverse cardiovascular consequences. Proactive surveillance and targeted interventions are required to minimize these metabolic complications, and a unified definition for pediatric MetS would improve identification and monitoring.
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Affiliation(s)
- Harriet M Gunn
- 1 Academic Department of Adolescent Medicine, The Children's Hospital at Westmead , Westmead, Australia .,2 Discipline of Paediatrics and Child Health, The University of Sydney , Sydney, Australia
| | - Hanna Emilsson
- 3 The Faculty of Medicine and Health Sciences, Linköping University , Linköping, Sweden
| | - Melissa Gabriel
- 4 Long-Term Follow-Up Clinic, Department of Oncology, The Children's Hospital at Westmead , Westmead, Australia
| | - Ann M Maguire
- 2 Discipline of Paediatrics and Child Health, The University of Sydney , Sydney, Australia .,5 Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead , Westmead, Australia
| | - Katharine S Steinbeck
- 1 Academic Department of Adolescent Medicine, The Children's Hospital at Westmead , Westmead, Australia .,2 Discipline of Paediatrics and Child Health, The University of Sydney , Sydney, Australia
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Delfino Duarte PA, Fumagalli AC, Wandeur V, Becker D. Urinary neutrophil gelatinase-associated lipocalin in critically ill surgical cancer patients. Indian J Crit Care Med 2015; 19:251-6. [PMID: 25983430 PMCID: PMC4430742 DOI: 10.4103/0972-5229.156459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND AIMS Neutrophil gelatinase-associated lipocalin (N-GAL) is an early biomarker of acute kidney injury (AKI) due to various etiologies. On the other hand, N-GAL is also elevated in patients with acute inflammatory conditions and in several solid neoplasms. The goal of this study was to assess the efficacy of N-GAL as a predictor of AKI and mortality in oncological surgical patients postoperatively in the intensive care unit (ICU). METHODS This was a prospective cohort observation study on adult cancer patients submitted to elective or emergency surgeries and admitted in the ICU. Urinary N-GAL was measured at the first 2 h after admission. AKI incidence and other complications were assessed, including hospital mortality. RESULTS A total of 22 patients were assessed (77% male, age 52.8 years, Acute Physiology and Chronic Health Evaluation II [APACHE II] 17.3) in whom the most frequent site of cancer was the gastrointestinal tract. AKI incidence was 13.6%. Urinary N-GAL was a predictor of AKI (22.0 ng/ml in patients without AKI vs. 239.1 ng/ml in patients with AKI, P < 0.001). Multivariate analysis showed that the main predictors of AKI were age, APACHE II, and N-GAL. N-GAL was also higher, although not statistically significant in patients who died in the hospital. CONCLUSIONS In oncological postoperative patients admitted to the ICU, urinary N-GAL was an independent predictor of AKI; moreover, its level was higher in the deceased patients.
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Affiliation(s)
- Pericles Almeida Delfino Duarte
- From: General Intensive Care Unit, Cancer Hospital/Western Paraná State League for Cancer Treatment and Research (UOPECCAN), Cascavel, PR, Brazil
| | - Andreia Cristina Fumagalli
- From: General Intensive Care Unit, Cancer Hospital/Western Paraná State League for Cancer Treatment and Research (UOPECCAN), Cascavel, PR, Brazil
| | | | - Delmiro Becker
- From: General Intensive Care Unit, Cancer Hospital/Western Paraná State League for Cancer Treatment and Research (UOPECCAN), Cascavel, PR, Brazil
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10
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Girardot T, Prothet J, Page M, Juillard L, Rimmelé T. [Acute kidney injury and cancer]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2014; 33:290-292. [PMID: 24698586 DOI: 10.1016/j.annfar.2014.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 03/05/2014] [Indexed: 06/03/2023]
Affiliation(s)
- T Girardot
- Département d'anesthésie-réanimation, service P-réanimation, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - J Prothet
- Département d'anesthésie-réanimation, service P-réanimation, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - M Page
- Département d'anesthésie-réanimation, service P-réanimation, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - L Juillard
- Service de néphrologie, pavillon P, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - T Rimmelé
- Département d'anesthésie-réanimation, service P-réanimation, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France.
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11
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Campbell GA, Hu D, Okusa MD. Acute kidney injury in the cancer patient. Adv Chronic Kidney Dis 2014; 21:64-71. [PMID: 24359988 DOI: 10.1053/j.ackd.2013.08.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 08/19/2013] [Accepted: 08/19/2013] [Indexed: 02/08/2023]
Abstract
Acute kidney injury (AKI) is a frequent and significant complication of cancer and cancer therapy. Cancer patients frequently encounter risk factors for AKI including older age, CKD, prerenal conditions, sepsis, exposure to nephrotoxins, and obstructive physiology. AKI can also be secondary to paraneoplastic conditions, including glomerulonephritis and microangiopathic processes. This complication can have significant consequences, including effects on patients' ability to continue to receive therapy for their malignancy. This review will serve to summarize potential etiologies of AKI that present in patients with cancer as well as to highlight specific patient populations, such as the critically ill cancer patient.
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12
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Lameire N. Nephrotoxicity of recent anti-cancer agents. Clin Kidney J 2013; 7:11-22. [PMID: 25859345 PMCID: PMC4389154 DOI: 10.1093/ckj/sft135] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 10/08/2013] [Indexed: 12/14/2022] Open
Abstract
Cancer patients may develop a variety of kidney lesions that impair not only their immediate survival but also limit the adequate treatment of the underlying malignant process. This review summarizes the nephrotoxic potential of some of the most recently developed anti-cancer drugs, focusing on those interfering with the vascular endothelial growth factor and epidermal growth factor receptor pathways and mammalian target of rapamycin inhibitors. Thrombotic microangiopathy (haemolytic-uraemic syndrome), proteinuria, hypertension and magnesium depletion are the most common side effects. Also the risk for developing acute kidney injury in patients with advanced prostate cancer undergoing androgen deprivation therapy is discussed.
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Affiliation(s)
- Norbert Lameire
- University Hospital , 185, De Pintelaan, Gent 9000 , Belgium
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