title: Carfilzomib-related acute kidney injury may be prevented by N-acetyl-L-cysteine.
abstract: Carfilzomib is a second-generation epoxyketone proteasome inhibitor that is approved for treatment of relapsed and refractory multiple myeloma. Phase 2 trials have reported that 25% of treated patients have renal adverse effects. Pre-renal/vasoconstriction-related insult from this chemotherapy agent has been documented. We describe a case of a 78-year-old man with refractory multiple myeloma with acute kidney injury associated with carfilzomib treatment. We show that use of N-acetyl-l-cysteine in our patient partially mitigated the renal injury upon re-challenge. This case report hypothesizes that acute renal injury from carfilzomib is caused by vasoconstriction of the renal vessels, which may be prevented by N-acetyl-l-cysteine.
authors.affiliation: Division of Kidney Diseases and Hypertension, Hofstra NS-LIJ School of Medicine, Great Neck, NY, USA.
authors.forename: Rimda
authors.initials: R
authors.lastname: Wanchoo
authors.affiliation: Division of Kidney Diseases and Hypertension, Hofstra NS-LIJ School of Medicine, Great Neck, NY, USA.
authors.forename: Seyyar
authors.initials: S
authors.lastname: Khan
authors.affiliation: Don Monti Division of Oncology/Division of Hematology, Department of Medicine, Hofstra North Shore-LIJ School of Medicine, Lake Success, New York.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Kolitz
authors.affiliation: Division of Kidney Diseases and Hypertension, Hofstra NS-LIJ School of Medicine, Great Neck, NY, USA kdj200@gmail.com.
authors.forename: Kenar D
authors.initials: KD
authors.lastname: Jhaveri
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D006801:Humans; D008297:Male; D009842:Oligopeptides / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents; D009842:Oligopeptides; C524865:carfilzomib; D000111:Acetylcysteine
keywords: Carfilzomib; N-acetyl-l-cysteine; acute renal failure; chemotherapy; kidney injury; myeloma