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

Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
Seminars in Nephrology (Impact Factor: 2.83). 11/2010; 30(6):570-81. DOI: 10.1016/j.semnephrol.2010.09.005
Source: PubMed

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.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The effects of chemotherapy in multiple organ systems may be challenging to discern from the sequelae of malignancy and systemic illnesses with concomitant immunocompromise. Chemotherapeutic agents typically affect multiple organ systems. Intrathecal medication errors may pose particularly devastating neurologic consequences and death, often requiring emergent intervention. This article provides an overview of commonly used chemotherapeutic drugs, indications for use, their adverse effects by organ system, and the management of commonly encountered toxicities. Intrathecal medication errors and specific antidotes are discussed in pertinent management sections. Emergency department management should focus on rapid patient assessment, immediate intervention following intrathecal medication errors, exclusion of infection, and excellent supportive care.
    Emergency medicine clinics of North America 02/2014; 32(1):167-203. · 0.96 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Lilii Bulbus is a popular folk medicine in the worldwide and has attracted great attention due to its bioactivity against respiratory system diseases (include lung cancers). This study was the first report providing in vivo evidences of antitumor potential of the bioactive polysaccharide from Lilii Bulbus. One major fraction (LBP-1) was obtained by purifying the crude polysaccharides extracted from Lilii Bulbus. Chemical characterization analysis indicated that LBP-1 was only a glucan, whose average molecular weight was 30.5kDa. Intraperitoneal administration of LBP-1 at the doses of 50-200mg/kg significantly inhibited the growth of Lewis lung carcinoma. Moreover, it could also obviously increase macrophage phagocytosis, splenocytes proliferation and cytokine (TNF-α, IL-2, IL-6 and IL-12) production to participate in the antitumor effects. LBP-1 could act as antitumor agent with immunomodulatory activity.
    Carbohydrate polymers. 02/2014; 102:543-9.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Idiopathic membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in adults, and 25% of MN patients proceed to ESRD. Urokinase plasminogen activator (uPA) may play an important role in reducing renal fibrosis. This study was conducted to clarify the relationship between uPA gene polymorphisms and clinical manifestations of MN. We recruited 91 biopsy-diagnosed MN patients and 105 healthy subjects. Genotyping of uPA gene 3'-UTR T/C polymorphism was performed by polymerase chain reaction methods. The genotype distribution had no effect on the development of MN. Thirteen patients (15.9%; P = 0.008) acquired malignancies and seventeen (20.7%; P = 0.006) patients progressed to ESRD with the C/C genotype, but no patients with the T/C genotype did. In conclusion, we demonstrated that the presence of the uPA gene 3'-UTR C/C genotype was associated with ESRD as well as acquired malignancies in MN patients. These findings should prompt specific considerations for the treatment of MN patients to maintain a balance between treating disease entities and protecting the immune system from cancers.
    BioMed research international. 01/2014; 2014:425095.