Considering renal risk while managing cancer

Abstract

Renal function is an important consideration in the management of patients with advanced cancer. There is a reciprocal relationship between cancer and the kidney: chronic kidney disease can increase the risk of developing cancer, and patients with cancer often experience renal impairment owing to age, disease-related factors and nephrotoxic treatments. As therapies for cancer continue to improve, patients are living longer with their disease, potentially extending the period over which they are susceptible to long-term complications. Furthermore, secondary symptoms, such as bone metastases or infections, may arise that will require treatment. Certain treatments, including chemotherapy, antibiotics and some bone-targeted agents, are nephrotoxic and may require dose modifications or interruptions to prevent renal injury. Nephrologists should play a key role in the identification and management of renal impairment in patients with cancer. Furthermore, they may be able to provide advice on protecting the kidneys in instances where nephrotoxic agents require dose reductions or interruptions, and when novel therapies or combinations are used. Collaboration between oncologists and nephrologists is important to optimal patient management. This article reviews the relationship between cancer and kidney disease and examines the treatments that may impact kidney function. Considerations for monitoring renal function are also discussed.

Effect of Heavy Metals on Creatinine Level in Human Blood Samples of Inhabitants Living in the Vicinity of Hudiara Drain, Lahore, Pakistan

“…The microwave-assisted acid digestion method was used to prepare samples for heavy metals determination as it needs 5-minutes for complete biological digestion of blood [23]. Jaffe's method was used to analyze Serum creatinine using standards and reagents [2,24]. The same blood sample was used for the determination of heavy metals (Pb, Hg and Cd) and creatinine.…”

“…Balali-Mood has tried to find an association between heavy metals concentration in food, water and air, and humanhealth. Metals like chromium, iron, copper, zinc, cobalt, selenium, magnesium, molybdenum, chromium, and manganese are essential for life, whereas arsenic, cadmium, mercury, nickel, lead and palladium are toxic for humans at diverse levels [2]. Earlier researchers found cumulative effects by exposure.…”

“…Tubular injury causes significant fluctuations in serum creatinine levels [2]. Chronic kidney disease (CKD) is widely recognized as an epidemic in developing and developed countries.…”

The Effect of Radiotherapy and Chemotherapy on Some Kidney and Liver Functions in Colorectal Cancer Patients

“…These symptoms occur within four months after exposure to radiation of the liver as the patient suffers from fatigue, weight gain, enlarged liver, and high alkaline phosphatase Which is not compatible with other liver enzymes (20) . In contrast to this «classic» RILD, a cancer patient may present with underlying chronic liver disease such as cirrhosis and viral hepatitis with liver function abnormalities such as jaundice within three months of completion of radiotherapy (21) .…”

Renal and Cardiovascular Toxicities by New Systemic Treatments for Prostate Cancer

“…However, a subsequent meta-analysis did not find any association between ADT and cardiovascular disease but it underlined a lower risk of disease-related and all-cause mortality during ADT [15]. In addition, ADT can increase the risk of kidney injury due to metabolic alterations and by lowering testosterone to castration levels, antagonizing the vasodilating effects of testosterone on renal vessels [16,17]. Several studies described a potential kidney injury during bicalutamide treatment.…”