title: [Anticancer drug-induced nephrotoxicity].
abstract: Nephrotoxicity is an inherent adverse effect of certain anticancer drugs. Anti neoplasic drugs have a narrow therapeutic index and the amount of drug necessary to produce a significant reduction in tumour burden usually produces significant nephrotoxicity. The dosage used in clinical trials represents often the maximum tolerated doses determined during phase I drug evaluation. Greater toxicity is acceptable during curative therapy than during palliative therapy. But cancer patients often exhibit excretory reduced organ function. Modulation of pharmacokinetics and pharmacodynamics of these drugs in cancer patients is therefore necessary in order to improve tolerance. Patients with malignancies are particularly vulnerable to development of renal abnormalities. Conversely, patients with renal abnormalities who have undergone kidney transplantation are at high risk for malignancy. Clinical syndromes of renal involvement are diverse and sometimes insidious. Despite the recent advances in understanding the mechanism of anticancer drug nephrotoxicity, prevention still relies on drug dosage decrease and active screening for renal abnormalities as part of the usual biological work up in patients treated with anticancer drugs.
authors.affiliation: Service de Néphrologie, Hôpital Pitié-Salpêtrière, 83, Boulevard de l'Hôpital, 75013 Paris, France. corinne.bagnis@psl.ap-hop-paris.fr
authors.forename: Corinne
authors.initials: C
authors.lastname: Isnard-Bagnis
authors.forename: Bruno
authors.initials: B
authors.lastname: Moulin
authors.forename: Vincent
authors.initials: V
authors.lastname: Launay-Vacher
authors.forename: Hassan
authors.initials: H
authors.lastname: Izzedine
authors.forename: Isabelle
authors.initials: I
authors.lastname: Tostivint
authors.forename: Gilbert
authors.initials: G
authors.lastname: Deray
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects; D002986:Clinical Trials as Topic; D003404:Creatinine / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000473:pathology*; D007677:Kidney Function Tests; D010166:Palliative Care; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents; D003404:Creatinine; D002945:Cisplatin