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Author Topic: New chemo drugs and their renal toxicities

Posts: 219
Post New chemo drugs and their renal toxicities
on: October 26, 2012, 10:03

One of the chemotherapy regimen for non-small cell lung ca is – Carboplatin, Bevacizumab and Pemetrexed in combination. I saw a patient in my clinic who came for evaluation of CKD 3 and is on the above combination

Thought I should share the renal manifestations:-

Carboplatin-- need to watch for tubular dysfunction (Magnesium, Potassium wasting)

Bevacizumab-- it is VEGF inhibitor-- need to closely monitor proteinuria and Hypertension -- if worsening noted--- suggest increasing wash out period-- or using alternative agent.

Pemetrexed—it is folate antagonist--careful watch of creatinine clearance is mandated-- patients current creatinine clearance is 43.8 ( as per manufacturer instructions-- a dose is not studied for creatinine clearance less than 45)-- case reports showing Acute tubular necrosis, Acute interstitial nephritis, peripheral edema, Nephrogenic DI, Renal tubular acidosis have been published in literature.

Nirav Jasani
Renal fellow

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