title: Nephrotoxicity from chemotherapeutic agents: clinical manifestations, pathobiology, and prevention/therapy.
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.
authors.affiliation: Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA. mark.perazella@yale.edu
authors.forename: Mark A
authors.initials: MA
authors.lastname: Perazella
authors.forename: Gilbert W
authors.initials: GW
authors.lastname: Moeckel
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects; D004164:Diphosphonates / Q000009:adverse effects; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects; D007678:Kidney Glomerulus / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D007684:Kidney Tubules / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D008727:Methotrexate / Q000009:adverse effects; D000077268:Pamidronate; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced*; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents; D004164:Diphosphonates; D000077268:Pamidronate; D002945:Cisplatin; D007069:Ifosfamide; D008727:Methotrexate