Nephrotoxicity From Molecularly Targeted Chemotherapeutic Agents

Adv Chronic Kidney Dis. 2021 Sep;28(5):415-428.e1. doi: 10.1053/j.ackd.2021.09.003.

Abstract

The introduction of novel molecularly targeted therapies in the last 2 decades has significantly improved the patient survival compared to standard conventional chemotherapies. However, this improvement has been accompanied by a whole new spectrum of kidney adverse events. Although known as "targeted," many of these agents lack specificity and selectivity, and they have a tendency to inhibit multiple targets including those in the kidneys. Early detection and correct management of kidney toxicities is crucial to preserve kidney functions. The knowledge of these toxicities helps guide optimal and continued utilization of these potent therapies. The incidence, severity, and pattern of nephrotoxicity may vary depending on the respective target of the drug. Here, we review the mechanism of action, clinical findings of kidney adverse events, and their proposed management strategies.

Keywords: Acute kidney injury; Hypertension; Proteinuria; Targeted chemotherapies; Thrombotic microangiopathy.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / chemically induced
  • Acute Kidney Injury* / drug therapy
  • Antineoplastic Agents* / adverse effects
  • Humans
  • Kidney

Substances

  • Antineoplastic Agents