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Stent in kidney, right kidney not functioning, chemotherapy. Precautions to protect kidneys ?

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Posted on Sat, 26 May 2012
Question: This question is for a Nephrologist:
I am a 63 y/o male dx with PC in 2000, radical prostatectectomy in 2001. Since that time the cancer has metastasized to the bone, lungs and liver. I have kidney problems as well. A stent was placed in the right kidney in January 2010 due to swelling. I learned from my urologist after having a renal scan my urologist advises that my right kidney is not functioning at all and my left is not functioning too well. My question is how do I protect this kidney now. I will continue with my next chemo treatment in a week. I just began chemo as of 30 XXXXXXX
I am worried that my left kidney may shut down if I don't take measures to protect it. At this time my urologist is suggesting placing a stent in the left kidney.
Should I see a nephrologist and have him consult with my Oncologist? I am fearful of having kidney failure. What can I do righ now?
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Answered by Dr. Jasvinder Singh (1 hour later)
Hello,

Thanks for posting your query.

I can understand your concern for kidney well being especially when metastasis has occurred to the bone, lungs and liver. Moreover you are having renal failure of right side and this is aggravating the problem.

In such a case, first of all, it is advisable to avoid any nephrotoxic drugs which may cause acute renal failure or renal shotdown. Nephrotoxicity occurs when your body is exposed to a drug or toxin that causes damage to your kidneys. In your case, chemotherapy drugs like Cisplatin, Carboplatin, Carmustine, Mitomycin, high-dose Methotrexate may be nephrotoxic and hence these can be avoided.

NSAID’s (non steroidal anti-inflammatory drugs) which are often used as pain killers are also nephrotoxic.

It will be best to consult a nephrologist as well and the oncologist and nephrologist should work together for this.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Dr. Jasvinder Singh

Internal Medicine Specialist

Practicing since :1998

Answered : 1578 Questions

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Stent in kidney, right kidney not functioning, chemotherapy. Precautions to protect kidneys ?

Hello,

Thanks for posting your query.

I can understand your concern for kidney well being especially when metastasis has occurred to the bone, lungs and liver. Moreover you are having renal failure of right side and this is aggravating the problem.

In such a case, first of all, it is advisable to avoid any nephrotoxic drugs which may cause acute renal failure or renal shotdown. Nephrotoxicity occurs when your body is exposed to a drug or toxin that causes damage to your kidneys. In your case, chemotherapy drugs like Cisplatin, Carboplatin, Carmustine, Mitomycin, high-dose Methotrexate may be nephrotoxic and hence these can be avoided.

NSAID’s (non steroidal anti-inflammatory drugs) which are often used as pain killers are also nephrotoxic.

It will be best to consult a nephrologist as well and the oncologist and nephrologist should work together for this.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards.