Background: Kidney disease associated with cancer and anti-cancer therapies has been
increasingly recognized in the field of onco-nephrology. In particular, drug-induced nephrotoxicity
has important implications since most chemotherapeutic agents have a nephrotoxic potential. Also,
standard creatinine clearance methods used for the measurement of kidney function have been questioned
in cancer patients due to factors like low muscle mass and poor nutritional status. Overestimations
of the glomerular filtration rate, not only can increase the nephrotoxic potential of different
agents, but also further limit the use of first-line therapies.
Objective: This review covers specifically the drug-induced thrombotic microangiopathy and its
two pathophysiologic mechanisms which include immune or idiosyncratic reactions, and non-immune
or dose-dependent ones.
Conclusion: As novel cancer therapies are developed, it is paramount to pursue a better understanding
of conventional and novel chemotherapeutic agents and their role in kidney disease.