Nephrotoxicity in cancer treatment: An overview

Santos, Maria Luísa Cordeiro; Brito, Breno Bittencourt de; Silva, Filipe Antônio França da; Botelho, Anelise Costa dos Santos; Melo, Fabrício Freire de

doi:10.5306/wjco.v11.i4.190

Cited by 71 publications

(51 citation statements)

References 133 publications

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“…AKI is of particular concern for cancer patients as AKI is associated with the subsequent development of CKD, and CKD is associated with adverse post-operative outcomes in patients with prostate, kidney, and bladder cancer (17)(18)(19). Furthermore, CKD may reduce the oncologist's clinical armamentarium as several chemotherapeutic agents are nephrotoxic and optimal surveillance imaging often requires iodinated contrast enhancement (16).…”

Section: Discussionmentioning

confidence: 99%

“…AKI occurs in an estimated 4.5-8.9% of COVID19 cases (13,14). AKI increases the risk of developing CKD (15), which is concerning for cancer patients as many oncologic therapies may result in renal impairment (16). Additionally, in patients with genitourinary malignancies, CKD has been associated with adverse post-operative outcomes (17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

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Cancer, Mortality, and Acute Kidney Injury Among Hospitalized Patients with SARS-CoV-2 Infection

Khusid

Becerra

Gallante

et al. 2020

Preprint

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Background: To evaluate COVID19 patients treated within our academic medical system to determine if history of malignancy, both in general and specifically in genitourinary oncology patients, is associated with adverse clinical outcomes, including AKI and mortality. Methods: We conducted a retrospective cohort study among patients with confirmed SARS-CoV-2 infection in a multi-hospital, academic medical institution in New York City. Outcomes included mortality, ICU admission and AKI among hospitalized patients. We also evaluated risk of hospitalization among all patients with SARS-CoV-2 infection. Multilevel logistic regression models were used for analysis. Results: We identified 6,893 patients who met inclusion criteria, of which 4,018 were hospitalized. Among hospitalized patients 374 (9%) had a history of cancer, 281 (7%) experienced AKI, and 1,045 (26%) died. In adjusted analyses, patients with a history of cancer had 1.33 (95% CI = 1.05, 1.69) times the odds of death compared to those without cancer and this appeared to be driven by lung cancer (OR= 2.44, 95% CI= 1.05, 4.39). Patients with a history of genitourinary cancer were not at higher risk of mortality compared to those without cancer (OR=0.99, 95% CI= 0.61, 1.62). History of cancer was not associated with ICU admission or AKI in overall and subgroup analyses. Conclusions: Patients with a history of cancer who are hospitalized with SARS-CoV-2 infection are not at greater risk for AKI, though they are at higher risk for mortality as compared to patients without a history of cancer. The increased risk in mortality appears driven by patients with pulmonary neoplasms. Patients with a history of genitourinary malignancies do not appear to be at higher risk for AKI or for mortality compared to the general population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cancer, Mortality, and Acute Kidney Injury Among Hospitalized Patients with SARS-CoV-2 Infection

Khusid

Becerra

Gallante

et al. 2020

Preprint

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“…Treatment modalities were divided into four groups: surgery only, surgery and chemotherapy, chemotherapy only, and neither surgery nor chemotherapy, respectively. Radiation therapy was excluded from our analysis because it was thought that radiation had little effect on the kidney function [18]. We investigated whether the chemotherapeutic agents known to have nephrotoxicity including cisplatin, carboplatin, ifosfamide, gemcitabine, and pemetrexed were administered during the study period [19].…”

Section: Data Collectionmentioning

confidence: 99%

Clinical Significance of Acute Kidney Injury in Lung Cancer Patients

et al. 2021

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Acute kidney injury (AKI) in cancer patients is associated with increased morbidity and mortality. The incidence of AKI in lung cancer seems to be relatively higher compared with other solid organ malignancies, although its impact on patient outcomes remains unclear. Materials and MethodsThe patients newly diagnosed with lung cancer from 2004 to 2013 were enrolled in this retrospective cohort study. The patients were categorized according to the presence and severity of AKI. We compared all-cause mortality and long-term renal outcome according to AKI stage. ResultsA total of 3,202 patients were included in the final analysis. AKI occurred in 1,783 (55.7%) patients during the follow-up period, with the majority having mild AKI stage 1 (75.8%).During the follow-up of 2.6 ± 2.18 years, total 1,251 (53.7%) patients were died and 5-yr survival rate was 46.9%. We found that both AKI development and severity were independent risk factors for all-cause mortality in lung cancer patients, even after adjustment for lung cancerspecific variables including the stage or pathological type. In addition, patients suffered from more severe AKI tend to encounter de novo CKD development, worsening kidney function, and end-stage kidney disease progression. ConclusionIn this study, more than half of the lung cancer patients experienced AKI during their diagnosis and treatment period. Moreover, AKI occurrence and more advanced AKI were associated with a higher mortality risk and adverse kidney outcomes.

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“…Platinum agents are mostly associated with tubular cell dysfunction and ATN, which are related to their uptake and accumulation in renal epithelial tubular cells [ 4 ]. Although AKI is less frequently reported during treatment with third generation platinum agents such as oxaliplatin, in comparison with cisplatin or carboplatin [ 20 ], there are several reports of ATIN during treatment with oxaliplatin.…”

Section: Drug-related Atinmentioning

confidence: 99%

“…On one side, neoplastic patients can present with AKI secondary to anticancer drug-associated nephrotoxicity. According to current expertise, nephrotoxicity can be associated with a wide range of underlying mechanisms, such as acute tubular necrosis (ATN), thrombotic microangiopathy (TMA), nephrotic syndrome of diverse etiologies, and also ATIN [ 4 ]. On the other hand, kidney failure can limit the therapeutic arsenal available for cancer treatment due to impaired excretion of drugs.…”

Section: Introductionmentioning

confidence: 99%

Acute Tubulointerstitial Nephritis in Clinical Oncology: A Comprehensive Review

Martínez-Valenzuela

Draibe

Fulladosa

et al. 2021

IJMS

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Acute kidney injury in patients who suffer a malignancy is a common complication. Due to its high prevalence and effective treatment, one of the most frequent causes that both oncologists and nephrologists must be aware of is acute tubulointerstitial nephritis (ATIN). ATIN is an immunomediated condition and the hallmark of the disease, with the presence of a tubulointerstitial inflammatory infiltrate in the renal parenchyma. This infiltrate is composed mainly of T lymphocytes that can be accompanied by macrophages, neutrophils, or eosinophils among other cells. One of the major causes is drug-related ATIN, and some antineoplastic treatments have been related to this condition. Worthy of note are the novel immunotherapy treatments aimed at enhancing natural immunity in order to defeat cancer cells. In the context of the immunosuppression status affecting ATIN patients, some pathogen antigens can trigger the development of the disease. Finally, hematological malignancies can also manifest in the kidney leading to ATIN, even at the debut of the disease. In this review, we aim to comprehensively examine differential diagnosis of ATIN in the setting of a neoplastic patient.

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Nephrotoxicity in cancer treatment: An overview

Cited by 71 publications

References 133 publications

Cancer, Mortality, and Acute Kidney Injury Among Hospitalized Patients with SARS-CoV-2 Infection

Cancer, Mortality, and Acute Kidney Injury Among Hospitalized Patients with SARS-CoV-2 Infection

Clinical Significance of Acute Kidney Injury in Lung Cancer Patients

Acute Tubulointerstitial Nephritis in Clinical Oncology: A Comprehensive Review

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