HOSHINO Junichi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Original article
Language English
Peer review Non peer reviewed
Title がん薬物療法時の腎障害診療ガイドライン2022(第3章)　がん薬物療法による腎障害への対策(Chapter 3: Management of kidney injury caused by cancer drug therapy, from clinical practice guidelines for the management of kidney injury during anticancer drug therapy 2022)
Journal Formal name：International Journal of Clinical Oncology
Abbreviation：Int J Clin Oncol
ISSN code：14377772/13419625
Domestic / ForeginForegin
Publisher シュプリンガー・ジャパン(株)
Volume, Issue, Page 28(10),pp.1315-1332
Author and coauthor Ando Yuichi, Nishiyama Hiroyuki, Shimodaira Hideki, Takano Nao, Sakaida Emiko, Matsumoto Koji, Nakanishi Koki, Sakai Hideki, Tsukamoto Shokichi, Komine Keigo, Yasuda Yoshinari, Kato Taigo, Fujiwara Yutaka, Koyama Takafumi, Kitamura Hiroshi, Kuwabara Takashige, Yonezawa Atsushi, Okumura Yuta, Yakushijin Kimikazu, Nozawa Kazuki, Goto Hideaki, Matsubara Takeshi, Hoshino Junichi, Yanagita Motoko, the Committee of Clinical Practice Guidelines for the Management of Kidney Disease During Anticance
Publication date 2023/10/28
Summary Cisplatin should be administered with diuretics and Magnesium supplementation under adequate hydration to avoid renal impairment. Patients should be evaluated for eGFR (estimated glomerular filtration rate) during the treatment with pemetrexed, as kidney injury has been reported. Pemetrexed should be administered with caution in patients with a CCr (creatinine clearance) < 45 mL/min. Mesna is used to prevent hemorrhagic cystitis in patients receiving ifosfamide. Febuxostat is effective in avoiding hyperuricemia induced by TLS (tumor lysis syndrome). Preventative rasburicase is recommended in high-risk cases of TLS. Thrombotic microangiopathy could be triggered by anticancer drugs and there is no evidence of efficacy of plasma exchange therapy. When proteinuria occurs during treatment with anti-angiogenic agents or multi-kinase inhibitors, dose reductions or interruptions based on grading should be considered. Grade 3 proteinuria and renal dysfunction require urgent intervention, including drug interruption or withdrawal, and referral to a nephrologist should be considered. The first-line drugs used for blood pressure elevation due to anti-angiogenic agents are ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin receptor blockers). The protein binding of drugs and their pharmacokinetics are considerably altered in patients with hypoalbuminemia. The clearance of rituximab is increased in patients with proteinuria, and the correlation with urinary IgG suggests similar pharmacokinetic changes when using other antibody drugs. AIN (acute interstitial nephritis) is the most common cause of ICI (immune checkpoint inhibitor)-related kidney injury that is often treated with steroids. The need for renal biopsy in patients with kidney injury that occurs during treatment with ICI remains controversial.
DOI 10.1007/s10147-023-02382-2
Document No. XA19140004<Pre 医中誌>
PMID 37453935