High-flux hemodialysis versus glucarpidase for methotrexate-associated acute kidney injury: What’s best?

Kidney-related adverse drug effects from chemotherapeutic agents can cause acute kidney injury that may influence cancer treatment and patient outcomes. Many current chemotherapy drugs are associated with acute kidney injury, including methotrexate which causes dose-dependent tubular injury. In this review, we will focus on the manifestations of kidney disease secondary to methotrexate and discuss management strategies. In particular, we will review the use of high-flux hemodialysis versus glucarpidase for reducing toxic serum levels of methotrexate.