High Dose Methotrexate-Induced Acute Kidney Injury: Incidence, Risk Factors, and Recovery
Sheron Latcha, Mohit Gupta, I‐Hsin Lin, Edgar A. Jaimes
Abstract
High dose methotrexate (HD MTX) (>1 g/m2) remains the first line therapy for many malignancies. The reported incidence of acute kidney injury (AKI) ranges from 1.8% to 38.6% because of varied definitions of AKI.1-3 The risk factors for AKI, long-term renal outcomes, the safety of redosing HD MTX following AKI, and survival when HD MTX is continued after AKI are not known. Because HD MTX is a life-extending and life-saving therapy, and because AKI can result in delays or termination of therapy with this drug, we took advantage of the large adult cohort at our cancer center to evaluate the rate of and risk factors for AKI, and the effect of AKI on long-term renal function and on survivorship when HD MTX is redosed following AKI.