Nephrotoxicity of anticancer drugs--an underestimated problem?

Nephrotoxicity is an inherent adverse effect of certain anticancer drugs and may result in a variety of functional consequences that include any combination of glomerular or tubular dysfunction, hypertension and disturbance of the renal endocrine function. The nephrotoxic potential of most anticancer agents dramatically increases in the presence of borderline or overt pre-existing chronic kidney disease and measurement of renal function is therefore of utmost importance in the cancer patient before any treatment is initiated. This review summarizes some clinical nephrotoxic side effects of a selection of the most frequently used anticancer drugs. The drugs discussed are cisplatin, methotrexate, ifosfamide, citumixab and panitumumab, mitocin C and gemcitabine and antiangiogenesis drugs.