Skip to main content

Advertisement

SpringerLink
Log in

How to manage the dose of drugs in cancer patients with acute kidney injury, practical recommendations

  • Commentary
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Acute kidney injury (AKI) and chronic kidney disease (CKD) are common in cancer patients. AKI is a brutal and reversible condition which makes it hard to manage from a pharmacological perspective when patients are receiving anticancer regimens and other supportive care drugs, such as anticoagulants, analgesics and other drugs. In contrast to CKD, which is a slow progressive disease, there is no clear guidance on how to manage and/or modify the dosage of drugs during AKI. Indeed, the slow progression of CKD allows physicians to monitor the renal function by using the glomerular filtration rate. Consequently, publications have explored the management of drugs in cancer patients with CKD, which is currently not the same for AKI. There are no recommendations or suggestions on how to manage drug doses in case of AKI in cancer patients. This commentary explores the different options to manage drugs (anticancer drugs, anticoagulants, and other supportive care drugs) during AKI in cancer patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Janus N, Launay-Vacher V, Byloos E, et al. Cancer and renal insufficiency results of the BIRMA study. Br J Cancer. 2010;103(12):1815–21. https://doi.org/10.1038/sj.bjc.6605979.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Launay-Vacher V, Oudard S, Janus N, et al. Prevalence of renal insufficiency in cancer patients and implications for anticancer drug management: the renal insufficiency and anticancer medications (IRMA) study. Cancer. 2007;110(6):1376–84. https://doi.org/10.1002/cncr.22904.

    Article  CAS  PubMed  Google Scholar 

  3. Travassos PNC, de Barros Silva PG, Freitas MO, et al. Risk factors for renal impairment in patients with hematological cancer receiving antineoplastic treatment. Support Care Cancer. 2022;30(9):7271–80. https://doi.org/10.1007/s00520-022-07159-3.

    Article  PubMed  Google Scholar 

  4. Mahmoodi BK, Gansevoort RT, Naess IA, et al. Association of mild to moderate chronic kidney disease with venous thromboembolism: pooled analysis of five prospective general population cohorts. Circulation. 2012;126(16):1964–71. https://doi.org/10.1161/CIRCULATIONAHA.112.113944.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ishigami J, Grams ME, Naik RP, et al. Chronic kidney disease and risk for gastrointestinal bleeding in the community: the atherosclerosis risk in communities (ARIC) study. Clin J Am Soc Nephrol. 2016;11(10):1735–43. https://doi.org/10.2215/CJN.02170216.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Zimmer-Rapuch S, Lheureux S, Brocard F, et al. Anticancer drugs management in renal insufficiency patients. Bull Cancer. 2012;99(3):323–31. https://doi.org/10.1684/bdc.2011.1489.

    Article  PubMed  Google Scholar 

  7. Janus N, Thariat J, Boulanger H, et al. Proposal for dosage adjustment and timing of chemotherapy in hemodialyzed patients. Ann Oncol. 2010;21(7):1395–403. https://doi.org/10.1093/annonc/mdp598.

    Article  CAS  PubMed  Google Scholar 

  8. Launay Vacher V, Svetlana K, Deray G. GPR® anticancéreux. 4th ed. Paris: Méditions International; 2010. ISBN: 2848020164.

    Google Scholar 

  9. Christiansen CF, Johansen MB, Langeberg WJ, et al. Incidence of acute kidney injury in cancer patients: a Danish population-based cohort study. Eur J Intern Med. 2011;22(4):399–406. https://doi.org/10.1016/j.ejim.2011.05.005.

    Article  PubMed  Google Scholar 

  10. Liborio AB, Abreu KL, Silva GB Jr, et al. Predicting hospital mortality in critically ill cancer patients according to acute kidney injury severity. Oncology. 2011;80(3–4):160–6. https://doi.org/10.1159/000329042.

    Article  PubMed  Google Scholar 

  11. Aloy B, Janus N, Isnard-Bagnis C, et al. Renal toxicity of anticancer drugs. Nephrol Ther. 2021;17(7):553–63. https://doi.org/10.1016/j.nephro.2021.09.001.

    Article  PubMed  Google Scholar 

  12. Cosmai L, Porta C, Foramitti M, et al. Preventive strategies for acute kidney injury in cancer patients. Clin Kidney J. 2021;14(1):70–83. https://doi.org/10.1093/ckj/sfaa127.

    Article  CAS  PubMed  Google Scholar 

  13. Samuels J, Ng CS, Nates J, et al. Small increases in serum creatinine are associated with prolonged ICU stay and increased hospital mortality in critically ill patients with cancer. Support Care Cancer. 2011;19(10):1527–32. https://doi.org/10.1007/s00520-010-0978-7.

    Article  PubMed  Google Scholar 

  14. Improving Global outcomes (KDIGO) Acute Kidney Injury Working Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Inter Suppl. 2012;2:1–138. https://doi.org/10.1038/kisup.2012.6.

  15. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31–41. https://doi.org/10.1159/000180580.

    Article  CAS  PubMed  Google Scholar 

  16. Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999;130(6):461–70. https://doi.org/10.7326/0003-4819-130-6-199903160-00002.

    Article  CAS  PubMed  Google Scholar 

  17. Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12. https://doi.org/10.7326/0003-4819-150-9-200905050-00006.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Carrier M, Blais N, Crowther M, et al. Treatment algorithm in cancer-associated thrombosis: updated Canadian expert consensus. Curr Oncol. 2021;28(6):5434–51. https://doi.org/10.3390/curroncol28060453.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Izzedine H, Launay Vacher V, Deray G. GPR® antalgiques et anti-inflammatoires. 1st ed. Paris: Méditions International; 2003. ISBN: 2848020164.

    Google Scholar 

  20. Launay-Vacher V, Karie S, Fau JB, et al. Treatment of pain in patients with renal insufficiency: the World Health Organization three-step ladder adapted. J Pain. 2005;6(3):137–48. https://doi.org/10.1016/j.jpain.2004.11.009.

    Article  PubMed  Google Scholar 

  21. Scott LJ, Perry CM. Tramadol: a review of its use in perioperative pain. Drugs. 2000;60(1):139–76. https://doi.org/10.2165/00003495-200060010-00008.

    Article  CAS  PubMed  Google Scholar 

  22. Polat EC, Koc A, Demirkan K. The role of the clinical pharmacist in the prevention of drug-induced acute kidney injury in the intensive care unit. J Clin Pharm Ther. 2022;47(12):2287–94. https://doi.org/10.1111/jcpt.13811.

    Article  PubMed  Google Scholar 

  23. Pehlivanli A, Eyupoglu S, Basgut B, et al. Impact of a multidisciplinary approach involving clinical pharmacist on resolving drug related problems in chronic kidney patients: a prospective interventional study. BMC Nephrol. 2023;24(1):149. https://doi.org/10.1186/s12882-023-03210-5.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hou J, Li JF, Yan XJ, et al. The effect of clinical pharmacist intervention on renal function impairment in patients with antimicrobial-induced acute kidney injury in ICU. Patient Prefer Adherence. 2023;17:711–8. https://doi.org/10.2147/PPA.S397873.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Launay-Vacher V, Rey JB, Isnard-Bagnis C, et al. Prevention of cisplatin nephrotoxicity: state of the art and recommendations from the European Society of Clinical Pharmacy Special Interest Group on Cancer Care. Cancer Chemother Pharmacol. 2008;61(6):903–9. https://doi.org/10.1007/s00280-008-0711-0.

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

None funding for this article.

Author information

Authors and Affiliations

  1. Global Medical Affairs, Global Thrombosis Strategy, LEO Pharma, Paris, France

    Nicolas Janus

  2. Department of Pharmacy, Grand Hopital de Charleroi, Charleroi, Belgium

    Pierre-Yves Desplanques

Authors
  1. Nicolas Janus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pierre-Yves Desplanques
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicolas Janus.

Ethics declarations

Conflicts of interest

NJ is an employee of LEO Pharma and reports direct and undirect fees from Baxter, Bayer, B-Braun, Boehringer-Ingelheim, Daichii Sankyo, Fresenius Medical Care, Gilead, Ipsen, Leo Pharma, Pfizer, Pierre Fabre Oncology, Roche, Sanofi, Teva, Vifor Pharma, and ViiV. P-YD declare a paid participation in a board organized by Leo Pharma regarding the good practice on use of heparins in a community setting in 2017.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Janus, N., Desplanques, PY. How to manage the dose of drugs in cancer patients with acute kidney injury, practical recommendations. Int J Clin Pharm 46, 210–213 (2024). https://doi.org/10.1007/s11096-023-01656-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-023-01656-z

Keywords

Search

Navigation