Nephrotoxicity after radionuclide therapies

Parihar, Ashwin Singh; Chopra, Sejal; Prasad, Vikas

doi:10.1016/j.tranon.2021.101295

Cited by 23 publications

(12 citation statements)

References 80 publications

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“…As nearly 83% of the activity is eliminated by the kidney within 24 h, in patients with <30 mL/min GFR, the dose of Lu 177 Dotatate should be reduced by 75%-85% of the usual dose to account for the retention of uneliminated Lu 177 Dotatate. 20 Patients need to be informed about high likelihood of further reduction of their kidney function even with this low dose of radioligand. Infusion of amino acid in patients already under dialysis is not needed unless there is some amount of relevant renal function.…”

Section: Dose Considerations Including Amino Acid Infusionmentioning

confidence: 99%

Use of approved Lu‐177 radiopharmaceuticals in patients with end‐stage renal disease: A review of the literature and proposed treatment algorithm

Trikalinos,

Kim,

Vijayan

et al. 2024

J Neuroendocrinology

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Peptide receptor radionuclide therapy (PRRT) can be a very useful treatment for patients with neuroendocrine neoplasms and metastatic castration‐resistant prostate cancer but it is routinely avoided in those with advanced kidney disease because it can adversely affect the renal function. Accordingly, no clear guidelines exist on the use of PRRT for patients on hemodialysis (HD). We performed a literature review to identify publications on HD patients who received PRRT with Lutetium‐177 (Lu177) Dotatate and Y‐90 and obtained information on Lu177 pharmacokinetics and early testing data from the manufacturer. We also perused the most recent North American Neuroendocrine Tumor Society (NANETS)/European Neuroendocrine Tumor Society (ENETS) recommendations. Seven relevant publications with a total of 15 patients were included. Patients received dose‐adjusted fractions of PRRT with HD occurring usually within 24 h. There were no immediate or long‐term serious adverse events attributed to the radioligand, although data was limited. Using available evidence and input from a multidisciplinary group, we have created an institutional workflow. Dose‐adjusted PRRT can be offered to patients undergoing HD under careful, multidisciplinary supervision.

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Section: Dose Considerations Including Amino Acid Infusionmentioning

confidence: 99%

Use of approved Lu‐177 radiopharmaceuticals in patients with end‐stage renal disease: A review of the literature and proposed treatment algorithm

Trikalinos,

Kim,

Vijayan

et al. 2024

J Neuroendocrinology

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“…As mentioned above, EC is preferred over PC for lithium-ion batteries electrolyte formulation; this is expected to drive the market for EC production, which is the motivation behind producing EC over PC. Owing to EC’s vast range of applications (Figure ) and growing usage in various industries such as automotive, oil and gas, industry, and medicine, the global market for EC is expected to grow from USD 288 million in the year 2019 to USD 418.5 million in the year of 2027 at a compound annual growth rate (CAGR) of 6% . The market price of EC ranged from 1335 to 3200 USD per tonne in the year 2021 depending on the region, with Asia Pacific having the highest price .…”

Section: Literature Reviewmentioning

confidence: 99%

“…Motivation for ethylene carbonate production based on global market demand. All currency stated is in USD using data from ref (organic carbonate) and ref (ethylene carbonate). Data of the lithium-ion battery electrolyte solvent market are obtained from ref .…”

Section: Literature Reviewmentioning

confidence: 99%

Exploring Greener Pathways and Catalytic Systems for Ethylene Carbonate Production

Ng,

Minh Loy,

McManus

et al. 2023

ACS Sustainable Chem. Eng.

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The production of cyclic carbonates is pivotal in carbon capture and utilization (CCU), providing an opportunity to utilize recycled CO 2 . Ethylene carbonate (EC) holds significance among cyclic carbonates in industrial settings due to its extensive applications in lithium-ion batteries and industrial lubricants and as a precursor for green polycarbonate production. However, the current synthesis of EC relies on toxic, fossil-based epoxide reactants, which poses sustainability challenges. To meet the growing demand for green chemistry, three greener alternative pathways for EC synthesis have been proposed, involving the reaction of carbon-based reactants (CO 2 , urea, and dimethyl carbonate) with ethylene glycol (EG) derived from biodiesel waste. This Perspective addresses key inquiries surrounding alternative EC synthesis pathways through quantitative and qualitative assessments. Specifically, we elucidate (a) possible sustainable routes, (b) current advances in the first principle of kinetic and operational methods, and (c) differences in reactions from the perspectives of thermodynamics, safety, and greenness of production. Notably, the direct carboxylation of CO 2 with EG emerges as a promising green synthesis route, but challenges persist, such as catalyst development and water inhibition. Finally, future prospects for overcoming challenges in the green manufacturing of EC are discussed, providing insights into advancing CCU.

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“…Due to the renal excretion of radioisotopes used in RLT, the kidneys are the most vulnerable to radiation; thus, renal adverse events are often described in the literature. The number of nephrons in human kidneys is determined from birth, so their loss due to any injury leads to an irreparable decline in renal function [ 7 ]. Moreover, [ 177 Lu]Lu-DOTA-TATE or [ 90 Y]Y-DOTA-TATE are reabsorbed in proximal tubules by the endocytic megalin/cubilin receptor complex, resulting in the retention of radionuclides in the renal interstitium.…”

Section: Introductionmentioning

confidence: 99%

Renal Disturbances during and after Radioligand Therapy of Neuroendocrine Tumors—Extended Analysis of Potential Acute and Chronic Complications

Saracyn¹,

Durma²,

Bober³

et al. 2023

IJMS

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Neuroendocrine tumors (NEN) are a group of neoplasms that arise from hormonal and neural cells. Despite a common origin, their clinical symptoms and outcomes are varied. They are most commonly localized in the gastrointestinal tract. Targeted radioligand therapy (RLT) is a treatment option which has proven to be successful in recent studies. However, the possible outcomes and true safety profile of the treatment need to be fully determined, especially by new, more sensitive methods. Our study aimed to present an extended analysis of acute and chronic renal complications during and after radioligand therapy using, for the first time in the literature, innovative and complex renal parameters. Forty patients with neuroendocrine tumors underwent four courses of radioligand therapy with [177Lu]Lu-DOTATATE or [177Lu]Lu/[90Y]Y-DOTATATE. Radioisotopes were administrated in intervals of 8–12 weeks, with concurrent intravenous nephroprotection. New detailed and sensitive renal parameters were used to determine the renal safety profile during and after radioisotope therapy for standard treatment of NEN. During the first and fourth courses of RLT, no change in the glomerular filtration rate (GFR) was observed. However, long-term observations one year after the treatment showed a 10% reduction in the GFR. During the first course of treatment, the fractional urea and calcium excretions increased, while the fractional potassium concentration decreased. The fractional calcium excretion remained highly increased in long-term observations. Decreases in urine IL-18, KIM-1 and albumin concentrations were observed during RLT. The concentrations of IL-18 and KIM-1 remained low even a year after therapy. The ultrasound parameters of renal perfusion changed during treatment, before partially returning to the baseline one year after therapy, and were correlated with the biochemical parameters of renal function. A permanent increase in diastolic blood pressure was correlated with the decrease in the GFR observed during the study. In this innovative and complex renal assessment during and after RLT, we found a permanent 10% per year decrease in the GFR and noticeable disturbances in renal tubule function. The diastolic blood pressure also increased.

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Nephrotoxicity after radionuclide therapies

Cited by 23 publications

References 80 publications

Use of approved Lu‐177 radiopharmaceuticals in patients with end‐stage renal disease: A review of the literature and proposed treatment algorithm

Use of approved Lu‐177 radiopharmaceuticals in patients with end‐stage renal disease: A review of the literature and proposed treatment algorithm

Exploring Greener Pathways and Catalytic Systems for Ethylene Carbonate Production

Renal Disturbances during and after Radioligand Therapy of Neuroendocrine Tumors—Extended Analysis of Potential Acute and Chronic Complications

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