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Side EffectsKidney (renal) toxicity

Last update: 11/19/2014

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Resources

Topic Search: PubMed | Medscape | ASCO 

What do the kidneys do?

Drawing of the urinary tract in a male figure with labels for the kidneys, bladder, and ureters.The vital role of the kidneys is to sift out waste products from the blood and to remove extra water, which becomes urine.  The urine is then stored in the bladder until urination.   How well your kidneys are working is called renal function. 

How is poor kidney function detected?

When the kidneys are not working well, the waste products normally eliminated by the kidneys will be elevated in the blood. 

During treatment, markers of kidney toxicity can be expected and may get better with time.  Your doctor will measure concentrations of the waste substances in your blood and urine to monitor renal function:

bullet Elevated Plasma (blood) levels of:
Creatinine, blood urea nitrogen (BUN), and  electrolytes
 
bullet Elevated level of protein (proteinuria) in the urine.

The most sensitive marker of proteinuria is elevated urine albumin.

Causes of Renal toxicity (nephrotoxicity)

Kidney problems can occur when your body is exposed to a drug or toxin that causes damage to your kidneys.  These effects can be temporary and mitigated by maintaining hydration (drinking water).  But there are other causes or contributing factors to poor kidney function or damage:

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Certain chemotherapy drugs
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Radiation therapy - Dr. Eric Cohen: Radiation Nephropathy http://bit.ly/11tQgm3
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Some biologic therapies, such as interferon
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Intravenous (IV) contrast for imaging
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Blockage of blood flow to or from the kidney - by kidney stones or a tumor.
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Low blood pressure or irregular heart rhythms
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Being dehydrated
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Diuretics drugs
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Urinary infection, or inflammation of one or more of your kidneys
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Some antibiotics
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Heart disease and some drugs to treat heart conditions
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NSAID drugs
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Enlarged prostate gland
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Gastrointestinal tract or stomach bleeds (GI bleed).
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Too much protein in your diet
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Low blood pressure
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Diabetes
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A blockage of blood flow to or from the kidney. This may be caused by kidney stones or a tumor.

Can kidney stones cause kidney failure or damage? - KidneyStoners.org http://bit.ly/1vdJqyg
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Irregular heart rhythms can blood flow to the kidneys producing signs of kidney problems. 
 

How to Reduce the Risk of Treatment-related Renal toxicity

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Drinking plenty of water can reduce the risk of kidney damage of many drugs prior to treatment
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Limit use of Over the Counter Drugs, such as NSAIDS (ibuprofen).
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Limit proteins in your diet
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Limit or avoid alcohol during treatment
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Limit caffeine beverages during treatment

Symptoms of kidney disease (low function of the kidney) may include:

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Appetite loss
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General ill feeling and fatigue
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Headaches
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Itching (pruritus) and dry skin
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Nausea
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Weight loss without trying to lose weight

Source: MedlinePlus Medical Encyclopedia http://1.usa.gov/1pRELRc 

Symptoms that may occur when kidney function has gotten worse include:

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Abnormally dark or light skin
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Bone pain
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Drowsiness or problems concentrating or thinking
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Numbness or swelling in the hands and feet
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Muscle twitching or cramps
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Breath odor
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Easy bruising, or blood in the stool
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Excessive thirst
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Frequent hiccups
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Problems with sexual function
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Menstrual periods stop (amenorrhea)
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Shortness of breath
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Sleep problems
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Vomiting, often in the morning

Source: MedlinePlus Medical Encyclopedia http://1.usa.gov/1pRELRc 


Diet Recommendations and resources

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USDA Nutrient Database http://1.usa.gov/1sEdiNy
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Nutritional Values For Common Foods And Products http://bit.ly/1wUgsmk
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Low-phosphorus diet: Best for kidney disease? - Mayo Clinic http://mayocl.in/1wngpvi
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Diet and Nutrition Goals for People with Stage 3 Chronic Kidney Disease - DaVita http://bit.ly/14eblTx
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Diet - chronic kidney disease: MedlinePlus Medical Encyclopedia http://1.usa.gov/1xNtNLI
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Stage 3 Kidney Disease Diet - foods to eat and avoid http://bit.ly/1xNF3Yn
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The Stage 3 CKD Low Protein Diet | LIVESTRONG.COM http://bit.ly/1tHPkkL

 

Resources and related reports:

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Kidney involvement in leukemia and lymphoma. - PubMed - NCBI http://1.usa.gov/1A7Rv9z
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Acute kidney injury in the cancer patient. - PubMed - NCBI http://1.usa.gov/1uyIpQe

 
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Chemocare: Nephrotoxicity (Renal Toxicity) - Managing Side Effects - http://bit.ly/1q0h9tL
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Chronic Kidney Disease: Prevention and Treatment of Common Complications
http://www.aafp.org/afp/2004/1115/p1921.html 
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WebMD: Urine Test http://bit.ly/1sYUzNO
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Tests commonly used for screening, diagnosis, and monitoring:
Source: Lab Tests Online http://labtestsonline.org/understanding/conditions/kidney/start/3
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Chronic kidney disease: MedlinePlus Medical Encyclopedia http://1.usa.gov/1pRELRc
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Chemocare.com:  About Nephrotoxicity (Renal Toxicity)
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NIH: About Kidney function and disease http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/
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How to prevent, recognize, and treat drug-induced kidney toxicity - nephrotoxicity ~  - ccjm.org PDF
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Anticancer drug-induced kidney disorders.
Drug Saf. 2001 Jan;24(1):19-38. Review. PMID: 11219485
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Nephrotoxicity from chemotherapy: prevention and management.
Oncology (Huntingt). 1991 Oct;5(10):97-102, 105; disc. 105, 109-11. Review. PMID: 1838278
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Cisplatin Nephrotoxicity: A Review 

http://medicine-opera.com/wp-content/uploads/2008/05/cisplatin-nephrotoxicity.pdf
 
Disclaimer:  The information on Lymphomation.org is not intended to be a substitute for 
professional medical advice or to replace your relationship with a physician.
For all medical concerns,  you should always consult your doctor. 
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