Guidelines for Complications of Cancer Treatment Vol VIII Part B

Nephrotoxicity ofChemotherapeutic DrugsNephrotoxicity is an inherent adverse effect of certainanticancer drugs. Mechanisms of nephrotoxicity includechemotherapy induced damage to vasculature or structures ofthe kidneys, haemolytic uraemic syndrome and prerenalperfusion deficits. Patients with cancer are frequently at riskof renal impairment secondary to disease-related and iatrogeniccauses.Evaluation of Renal Function: In humans, the assessmentof renal function is mainly done by the measurement ofglomerular filtration rate (GFR) (1). Normal values, whichare related to age, sex, and body size, are approximately 130mL/min/1.73 m 2 in young men and 120 mL/min/1.73 m 2 inyoung women. Mean values decline as people age (2). Serumcreatinine is dependent on age, gender, race, body size, diet,certain drugs, and laboratory analytic methods (3). In earlyrenal disease, GFR can decrease substantially, without changesin serum creatinine. In late renal disease, the serum creatininelevel may rise disproportionately as GFR falls. The serumcreatinine does not significantly change until the Creatinineclearance rate (CCR) is less than 70 mL/min/1.73 m 2 thereforethe use of a single reference range for serum creatinine to447