Renal toxicities of antineoplastic drugs and bone marrow transplantation.

A number of antineoplastic chemotherapeutic drugs may produce fluid and electrolyte disturbances or nephrotoxic reactions extending across the clinical spectrum, from subclinical renal dysfunction to progressive chronic renal insufficiency to severe acute failure. Although some of the drugs that are highly nephrotoxic are now seldom used, others are tremendously useful in modern clinical oncology. Some newer antineoplastic therapies such as interleukin-2 and bone marrow transplantation are commonly associated with nephrotoxicity. Although our understanding of the pathophysiological mechanisms underlying these toxic reactions is still rather rudimentary, information derived from animal models, coupled with clinical experience, has in many circumstances generated clinical interventions that can successfully limit treatment-related renal injury.