[Chemotherapy and renal toxicity].
Antineoplastic drugs used in the treatment of cancers present with variable renal tolerance profiles. Among drugs with a potential for renal toxicity, platinum salts, methotrexate, and gemcitabine are well-known. The mechanisms of their renal toxicity and the means of its prevention are presented in this article. Anti-angiogenic drugs, recently marketed or still under clinical development, may also interact with the kidneys. In general, optimising the renal tolerance of anticancer drugs requires an appropriate evaluation of patients'renal function, before and during treatment, at each course. Serum creatinine alone is not a reliable index of renal function. Its evaluation must be performed with the use of Cockcroft-Gault or aMDRD formulae. In patients with abnormal renal function, dosage adjustment is often required to improve the renal tolerance, and also to limit the risk of extra-renal toxicities (such as haematological toxicities) induced by a drug overdosage, in those patients with reduced drug-elimination.
Service de néphrologie, hôpital de la Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75013 Paris, France. vincent.launay-vacher@psl.aphp.fr
Vincent
V
Launay-Vacher
Corinne
C
Isnard-Bagnis
Nicolas
N
Janus
Svetlana
S
Karie
Gilbert
G
Deray
D020533:Angiogenesis Inhibitors / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects*; D016190:Carboplatin / Q000009:adverse effects; D002330:Carmustine / Q000009:adverse effects; D002945:Cisplatin / Q000009:adverse effects; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D008130:Lomustine / Q000009:adverse effects; D008727:Methotrexate / Q000009:adverse effects; D009944:Organoplatinum Compounds / Q000009:adverse effects; D000077150:Oxaliplatin; D000093542:Gemcitabine
D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D008130:Lomustine; D016190:Carboplatin; D002945:Cisplatin; D002330:Carmustine; D008727:Methotrexate; D000093542:Gemcitabine