Nephrotoxicity can be a serious side effect of chemotherapy

Nephrotoxicity

Some of the neoplastic agents recognized for their potential nephrotoxic effects are ifosfamide, cyclophosphamide, cisplatin, methotrexate, streptozocin, and also the nitrosoureas.

Acute or chronic chemotherapy-induced nephrotoxicity may derive from the direct effect of those drugs on the kidney or even the glomerular distal tubule pathway.

The renal alterations are manifested by hemorrhagic cystitis, oliguria, dysuria, a heightened creatinine level, suprapubic discomfort, and back pain. Hyperuricemia is assigned to using high-dose methotrexate, and delayed renal failure may occur months to years after carmustine therapy.

Monitor renal function by checking serum creatinine, electrolytes, and creatinine clearance values before treatment. Ensure adequate hydration before and after treatment giving fluids intravenously and orally. Maintain adequate diuresis. Administer mannitol if indicated.

Alkalinization of the urine to some pH of more than 7 is essential to avoid precipitate formation with high-dose methotrexate administration. If oral those who are or citrovorum rescue is ordered, make sure the individual knows the significance of taking these medications as scheduled.

Let the patient to drink enough fluids before and after treatment. Give uroprotectants for example mesna or allopurinol to improve the crystals excretion, if ordered.

Teach the individual to void frequently, especially at bed time, to avoid urinary stasis. Instruct the individual to prevent foods that may irritate the bladder, for example coffee, tea, alcohol, and spices. Teach the individual indications of renal toxicity, their management, so when to report them.

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