Kidney Problems Caused by Cancer Treatment

What do my kidneys do?

You have two kidneys, one on each side of your body under your ribcage. They are bean-shaped and about the size of your fist. Kidneys help with many things, such as:

• Filtering out extra fluid, electrolytes (like sodium, calcium, magnesium, potassium), and toxins from your body to make urine.
• Removing acid from cells in your body.
• Making hormones that make red blood cells, keep your blood pressure normal, and help with your bone health.

Can treatment for cancer affect my kidneys?

Yes, some treatments for cancer can affect how your kidneys work. It is important to tell your care team if you have a history of kidney problems since some treatments can make these problems worse. Steps will be taken to help protect your kidneys. Blood work, like a comprehensive metabolic panel, and imaging tests can be done to check how well your kidneys are working.

Which cancer treatments can affect my kidneys?

Chemotherapy and Immunotherapy

Chemotherapy and immunotherapy medications that are systemic enter your bloodstream and go throughout your whole body. Your kidneys filter these medications and help them leave your body through your urine. Some chemotherapies and immunotherapies are known to cause kidney problems, so you may receive extra fluids, medications, or other treatments to prevent or lessen this damage.

Radiation Therapy

Radiation therapy to your kidneys or areas near your kidneys, like your abdomen (belly) and spine can damage your kidneys and how they work. The effect of radiation on your kidneys depends on:

• The dose of radiation.
• How often you receive it.
• Any kidney problems you might already have.

Your care team will try to limit the damage to your kidneys by making the radiation area as small and accurate as possible. Kidney damage from radiation can start within 6 to 12 months after receiving radiation (acute nephrotoxicity) or years after radiation (chronic nephrotoxicity).

Other Cancer Treatments

• Radiopharmaceutical Therapy (RPT): RPT is a treatment that uses a small amount of radioactive medicine given by vein (IV) or by mouth to treat cancer. It is a targeted type of treatment that attacks cancer cells, while mostly leaving healthy cells unharmed. Some of the RPT medications have a risk of kidney damage.
• Bone Marrow Transplant: The chemotherapy medications and radiation given before a bone marrow transplant can cause kidney problems. Kidney damage can be caused by the transplant process or by complications of the transplant, such as graft vs. host disease.
• Bisphosphonates: These medications can help make some bones stronger and can help prevent fractures (breaks). Bisphosphonates may be used with other therapies to treat bone metastasis. Some bisphosphonates can affect your kidneys.

Talk with your care team about the cancer treatments you are getting and your risk of kidney damage. Talk to your care team before taking any new medications.

What can I do to lessen or prevent kidney problems?

Before starting treatment for cancer, ask about things you should do at home to protect your kidneys, such as drinking enough fluids or following a certain diet.

When should I call my provider?

There are side effects that can happen if your kidney function is being affected. Call your provider right away if you have:

• Less urine output.
• New or worse swelling in your ankles, feet, or legs.
• Loss of appetite (not feeling hungry).
• Severe headache or dizziness.
• Blood in your urine.
• Shortness of breath.
• Itching.
• New or worse fatigue.
• Muscle cramps.

Talk with your care team about your risk of kidney problems from your specific cancer treatment and ask them any questions you may have.