Kidney and liver function and cancer

 

Impact associated with chemotherapy:
Adequate kidney and liver function is very important during chemotherapy, as well as throughout one’s life.

Many drugs are metabolized in the kidneys or liver.

Drugs that are metabolized in kidneys:

  • Drugs such as Cisplatin, Etoposide, Efosfamide, Cyclophosphamide, Zoledronic acid, and others can affect kidneys.
  • If your kidney function is not normal, the drug dose may need to be reduced or the drug cannot be used.

Drugs that are metabolized in the Liver:

  • Many drugs are metabolized in the liver.
  • These include Methotrexate, Taxol, Taxotere, Doxorubicin, Etoposide, and others.

Infectious hepatitis:

  • Patients with chronic hepatitis B and C may be at risk of reactivation (acute flare of hepatitis) during chemotherapy.
  • This appears to be more common in patients with hepatitis B.
  • Patients with history of hepatitis B and C should discuss the impact of chemotherapy with their doctors.

Patients with lymphoma receiving a drug called Rituxan (Rituximab) is at particularly elevated risk of reactivation (acute flare of hepatitis).

  • Therefore, they may require a drug called Epivir to suppress the hepatitis B virus during treatment.
  • Please discuss this with your oncologist prior to starting chemotherapy.

Patients with blockage of kidneys or liver

Sometimes cancer can cause kidney obstruction.

  • If the obstruction is not resolved by chemotherapy, a procedure called stenting to keep the ureter open may be considered.
  • A procedure called percutaneous nephrostomy to drain the urine and bypass the obstruction is also considered when stenting is not possible.

Patients with cancer that blocks the common bile duct that drains bile from the liver can develop jaundice.

  • If this is not resolved an internal procedure called stenting, which keeps the common bile duct open, may be considered.
  • If the above cannot be performed internally then a procedure done externally from outside through the skin (percutaneous) may be considered.

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