Electrolyte Disorders Induced by Antineoplastic Drugs

Ignazio Verzicco, Giuseppe Regolisti, Federico Quaini, Pietro Bocchi, Irene Brusasco, Massimiliano Ferrari, Giovanni Passeri, Valentina Cannone, Pietro Coghi, Enrico Fiaccadori, Alessandro Vignali, Riccardo Volpi, Aderville Cabassi

Research output: Contribution to journalReview article

Abstract

The use of antineoplastic drugs has a central role in treatment of patients affected by cancer but is often associated with numerous electrolyte derangements which, in many cases, could represent life-threatening conditions. In fact, while several anti-cancer agents can interfere with kidney function leading to acute kidney injury, proteinuria, and hypertension, in many cases alterations of electrolyte tubular handling and water balance occur. This review summarizes the mechanisms underlying the disturbances of sodium, potassium, magnesium, calcium, and phosphate metabolism during anti-cancer treatment. Platinum compounds are associated with sodium, potassium, and magnesium derangements while alkylating agents and Vinca alkaloids with hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion (SIADH). Novel anti-neoplastic agents, such as targeted therapies (monoclonal antibodies, tyrosine kinase inhibitors, immunomodulators, mammalian target of rapamycin), can induce SIADH-related hyponatremia and, less frequently, urinary sodium loss. The blockade of epidermal growth factor receptor (EGFR) by anti-EGFR antibodies can result in clinically significant magnesium and potassium losses. Finally, the tumor lysis syndrome is associated with hyperphosphatemia, hypocalcemia and hyperkalemia, all of which represent serious complications of chemotherapy. Thus, clinicians should be aware of these side effects of antineoplastic drugs, in order to set out preventive measures and start appropriate treatments.

Original languageEnglish (US)
Article number779
JournalFrontiers in Oncology
Volume10
DOIs
StatePublished - May 19 2020

Keywords

  • antidiuretic hormone (ADH)
  • antineoplastic drug exposure
  • electrolytes abnormalities
  • renal tubulopathies
  • tumor lysis syndrome

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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  • Cite this

    Verzicco, I., Regolisti, G., Quaini, F., Bocchi, P., Brusasco, I., Ferrari, M., Passeri, G., Cannone, V., Coghi, P., Fiaccadori, E., Vignali, A., Volpi, R., & Cabassi, A. (2020). Electrolyte Disorders Induced by Antineoplastic Drugs. Frontiers in Oncology, 10, [779]. https://doi.org/10.3389/fonc.2020.00779