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Nephrotoxizität bei Chemotherapie

Nephrotoxicity in chemotherapy

  • Leitthema
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Der Nephrologe Aims and scope

Zusammenfassung

Hintergrund

Die Nierenfunktion spielt eine entscheidende Rolle bei der Auswahl und Durchführung der Chemotherapie bei malignen Erkrankungen, welche aufgrund der potenziellen Nebenwirkungen richtig gewählt und eingesetzt werden muss.

Fragestellung

Chemotherapien können ein akutes Nierenversagen auslösen oder zur Entwicklung oder einem Fortschreiten einer chronischen Nierenkrankheit beitragen. Zudem kann eine eingeschränkte Nierenfunktion die Nebenwirkungsrate erhöhen, Dosisreduktionen erforderlich machen oder sogar zum Abbruch einer Therapie führen.

Material und Methoden

Wir stellen häufig verwendete, potenziell nephrotoxische chemotherapeutische Substanzen sowie entsprechende präventive Maßnahmen vor. Außerdem wird die thrombotische Mikroangiopathie (TMA) als unerwünschte Nebenwirkung von Chemotherapien beschrieben.

Ergebnisse

Die potenzielle Nephrotoxizität sollte bereits vor Therapieeinleitung bedacht werden, da sowohl das akute Nierenversagen als auch die chronische Nierenkrankheit akut und im Langzeitverlauf mit einer erhöhten Morbidität und Mortalität assoziiert sind.

Schlussfolgerung

Die enge Zusammenarbeit des Nephrologen und des Hämatoonkologen ist von großer Bedeutung, um dem Patienten die bestmögliche Therapie mit niedriger Nebenwirkungsrate anbieten zu können.

Abstract

Background

Renal function plays a crucial role in the choice and administration of chemotherapy. The chemotherapy of malignant diseases is associated with potential renal and non-renal adverse side effects and should, therefore, be correctly selected and implemented.

Objective

Chemotherapy can induce acute kidney injury or lead to the development or aggravation of chronic kidney disease. In addition, impaired renal function can exacerbate adverse events, necessitate reduction in dosing or even lead to termination of therapy.

Material and methods

We present commonly used potentially nephrotoxic chemotherapeutic substances and the corresponding preventive measures. Furthermore, we present thrombotic microangiopathy (TMA) as an undesired side effect triggered by various chemotherapeutic agents.

Results

Potential nephrotoxicity should be recognized before induction of therapy as acute kidney failure as well as chronic kidney disease are associated with increased morbidity and mortality during the acute phase as well as during long-term follow-up.

Conclusion

Cooperation between nephrologists and hematologist-oncologists is very important in order to provide the best therapy with the lowest rate of side effects for patients.

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Authors and Affiliations

  1. Universitätsklinikum Essen, Klinik für Nephrologie, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland

    M. Stavropoulou,  A. Kribben & A. Bienholz

Authors
  1. M. Stavropoulou
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  2. A. Kribben
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  3. A. Bienholz
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Corresponding author

Correspondence to A. Kribben.

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Interessenkonflikt

M. Stavropoulou, A. Kribben und A. Bienholz geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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M. Zeier, Heidelberg

J. Hoyer, Marburg

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Stavropoulou, M., Kribben, A. & Bienholz, A. Nephrotoxizität bei Chemotherapie. Nephrologe 11, 14–19 (2016). https://doi.org/10.1007/s11560-015-0029-y

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