Medications and extra fluid infusions can help protect your kidneys from damage during chemotherapy.

More than one million people receive chemotherapy or radiation treatments for their cancer each year in the United States. But for many people, their kidneys remove these chemotherapy drugs from their bodies and that leads to kidney damage.

To help protect your kidneys during chemotherapy treatments, your doctor will monitor your kidney health.

They may prescribe protective medications or offer more intravenous (IV) fluids to help drain chemotherapy waste from your body.

In some cases, chemotherapy treatments may need to be temporarily adjusted or stopped to improve kidney function.

Before starting chemotherapy, your doctors may perform a variety of tests to determine how healthy your kidneys are.

During chemotherapy, doctors may do a number of things to help protect your kidneys including:

  • checking fluid and electrolyte levels to see how well the kidneys are working
  • infusing the body with extra fluids to help flush chemotherapy drug waste out of the body
  • prescribing drugs like amifostine to help protect the kidneys
  • treating any other health issues
  • lowering chemotherapy levels or recommending dialysis if the kidneys are failing

Nephrotoxicity is a scientific term for declining kidney function related to toxic chemicals and medications. Nephrotoxins is the name given to substances that can lead to nephrotoxicity.

Some of the more common nephrotoxins in chemotherapy treatments are:

  • methotrexate
  • semustine
  • streptozocin
  • mithramycin
  • cisplatin

Nephrotoxins found in chemotherapy treatments can cause cysts, inflammation, and damage to structures in the kidneys. This can result in kidney dysfunction, chronic kidney disease, and even kidney failure.

In many cases, kidneys can recover from chemotherapy-related damage. When chemotherapy ends, and your kidneys no longer filter toxic chemicals, they may become healthier.

Some factors that affect whether the kidneys can recover from any chemotherapy damage include:

  • whether or not kidney problems were present before chemotherapy
  • the extent/length of the chemotherapy treatments
  • the specific drugs used in the chemotherapy treatments
  • if other treatments like radiation are also performed

Monitoring your kidneys can help navigate when chemotherapy drug levels need to be lowered, or treatments temporarily stopped to prevent long-term kidney damage.

A 2019 study following 163,071 people receiving chemotherapy or targeted drug treatments found acute kidney injury (AKJ) in 9.3% of them.

According to the study, injuries to the kidney were twice as likely to happen within the first 90 days following cancer treatment. The cancers with the highest rate of AKJ were myeloma, bladder, and leukemia.

An advanced cancer stage, preexisting kidney conditions, and diabetes were some of the factors linked with a higher rate of kidney injury.

Another study looked at the presence of kidney problems in children with cancer. It noted that 56% of the children faced kidney and urinary tract issues during and shortly after treatment.

Severe kidney disease was rare in long-term survivors but was significantly more common than in their siblings.

If chemotherapy injures your kidneys, your doctor may recommend lifestyle changes, medications, reducing the amount of chemotherapy being given, or even kidney dialysis.

Lifestyle strategies like not drinking and smoking can promote kidney health. Also, a diet low in sodium, potassium, and phosphorus can help your kidneys stay as healthy as possible. You can read more about that here.

Your doctor may also recommend regular physical activity and weight loss if you have overweight or live with obesity.

No specific medication can cure kidney disease. But drugs like diuretics may be helpful in removing extra fluids and waste from the body.

In some cases, doctors may suggest reducing the amount of chemo administered.

If the kidneys can’t properly filter and remove waste from the body, dialysis may be necessary.

Your kidneys can become damaged as they break down and remove chemotherapy drugs from your body.

To help prevent serious kidney damage, your doctors may offer more fluid in your infusions during chemotherapy treatments and prescribe protective medications.

They’ll perform tests to determine how healthy your kidneys are before beginning chemotherapy and continue to check your kidneys throughout the chemotherapy process.

If your kidneys become unable to properly filter waste out of your body, you may need to change your chemotherapy treatments or undergo dialysis.