Department of Internal Medicine, University of Texas Health Science Center-McGovern Medical School, Houston, TX; Department of Emergency Medicine, University of Texas- MD Anderson Cancer Center, Houston, TX.
Department of Medicine, Division of Nephrology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Adv Chronic Kidney Dis. 2021 Sep;28(5):415-428.e1. doi: 10.1053/j.ackd.2021.09.003.
The introduction of novel molecularly targeted therapies in the last 2 decades has significantly improved the patient survival compared to standard conventional chemotherapies. However, this improvement has been accompanied by a whole new spectrum of kidney adverse events. Although known as "targeted," many of these agents lack specificity and selectivity, and they have a tendency to inhibit multiple targets including those in the kidneys. Early detection and correct management of kidney toxicities is crucial to preserve kidney functions. The knowledge of these toxicities helps guide optimal and continued utilization of these potent therapies. The incidence, severity, and pattern of nephrotoxicity may vary depending on the respective target of the drug. Here, we review the mechanism of action, clinical findings of kidney adverse events, and their proposed management strategies.
在过去的 20 年中，新型的分子靶向治疗药物的引入显著提高了患者的生存率，与标准的常规化疗相比。然而，这种改善伴随着全新的一系列肾脏不良事件。尽管被称为“靶向”，但这些药物中的许多缺乏特异性和选择性，它们往往抑制多个靶点，包括肾脏中的靶点。早期发现和正确处理肾脏毒性对于保护肾脏功能至关重要。了解这些毒性有助于指导这些有效治疗方法的最佳和持续利用。肾毒性的发生率、严重程度和模式可能因药物的各自靶点而异。在这里，我们回顾了药物的作用机制、肾脏不良事件的临床发现及其提出的管理策略。
