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Nephrotoxicity associated with anticancer agents: perspective on onconephrology from nephrologists

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Abstract

Nephrotoxicity is one of the most important complications in cancer patients. In particular, acute kidney injury (AKI) is known to be associated with discontinuing effective oncological treatments, longer hospitalizations, increased costs, and a higher risk of death. In addition to acute kidney injury, clinical signs associated with nephrotoxicity during treatment with anticancer agents include chronic kidney disease, proteinuria, hypertension, electrolyte abnormalities, and other characteristic manifestations. Many of these signs are caused both by cancer treatment as well as by cancer itself. Therefore, it is important to carefully recognize whether the underlying causes of renal impairment in cancer patients are cancer-related, treatment-related, or both. This review describes the epidemiology and pathophysiology of anticancer agent-induced acute kidney injury, proteinuria, hypertension, and other characteristic manifestations.

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Acknowledgements

This study was supported by Grants-in-Aid for Scientific Research (C) (22K08350).

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Authors and Affiliations

  1. Department of Nephrology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Takeshi Matsubara, Hideki Yokoi & Motoko Yanagita

  2. Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Hiroyuki Yamada

  3. Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan

    Motoko Yanagita

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  1. Takeshi Matsubara
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  2. Hideki Yokoi
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Correspondence to Takeshi Matsubara.

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Conflict of interest

MY receives research grants from Mitsubishi Tanabe Pharma and Boehringer Ingelheim. H Yokoi has received research grants from Mitsubishi Tanabe Pharma, and honoraria from AstraZeneca and Mitsubishi Tanabe Pharma. The other authors declare no potential conflicts of interest.

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Matsubara, T., Yokoi, H., Yamada, H. et al. Nephrotoxicity associated with anticancer agents: perspective on onconephrology from nephrologists. Int J Clin Oncol 28, 625–636 (2023). https://doi.org/10.1007/s10147-023-02307-z

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