Strategies to prevent nephrotoxicity of anticancer drugs.
Nephrotoxicity is a relatively common and potentially serious adverse effect of treatment with certain cytotoxic drugs (especially ifosfamide). The patient may develop severe chronic proximal tubular toxicity. It is therefore very important to attempt to reduce the frequency and severity of acute and chronic nephrotoxicity resulting from chemotherapy. A logical approach is described, with particular reference to ifosfamide and cisplatin, involving improved evaluation of the important clinical features of nephrotoxicity and a greater understanding of its pathogenesis. This approach will facilitate the development of logical preventive strategies, or less toxic analogues, or both. The methods used may also enable prediction of the potential nephrotoxicity of newly developed cytotoxic agents.
Skinner
R
R
Sir James Spence Institute of Child Health, University of Newcastle upon Tyne, Royal Victoria Infirmary, UK.
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000633:toxicity*; D002460:Cell Line / Q000378:metabolism; D002614:Chelating Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000633:toxicity*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000378:metabolism / Q000633:toxicity*; D007668:Kidney / Q000187:drug effects*; D007674:Kidney Diseases / Q000139:chemically induced / Q000209:etiology / Q000517:prevention & control*; D007684:Kidney Tubules / Q000378:metabolism / Q000473:pathology; D015080:Mesna / Q000494:pharmacology / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy*; D011379:Prognosis; D012307:Risk Factors; D013885:Thiosulfates / Q000627:therapeutic use
D000970:Antineoplastic Agents; D002614:Chelating Agents; D013885:Thiosulfates; C017717:sodium thiosulfate; D015080:Mesna; D002945:Cisplatin; D007069:Ifosfamide