Cover Kidney News
Volume/Issue:
Volume 14: Issue 2
Page:
20
Publication Date:
01 Feb 2022
Online Publication Date:
04 Feb 2022
  • 1.

    Khan ZA, et al. Methotrexate: A detailed review on drug delivery and clinical aspects. Expert Opin Drug Deliv 2012; 9:151–169. doi: 10.1517/17425247.2012.642362

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    • Search Google Scholar
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  • 2.

    Widemann BC, Adamson PC. Understanding and managing methotrexate nephrotoxicity. Oncologist 2006; 11:694–703. doi: 10.1634/theoncologist.11-6-694

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    • Search Google Scholar
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  • 3.

    Mallipattu SK, Ross MJ. Methotrexate in the urine. Kidney Int 2011; 80:226. doi: 10.1038/ki.2011.97

  • 4.

    Howard SC, et al. Preventing and managing toxicities of high-dose methotrexate. Oncologist 2016; 21:1471–1482. doi: 10.1634/theoncologist.2015-0164

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  • 5.

    Lee JS, et al. Methotrexate-related toxicity in patients with rheumatoid arthritis and renal dysfunction. Rheumatol Int 2020; 40:765–770. doi: 10.1007/s00296-020-04547-y

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  • 6.

    Sparks JA, et al. Effect of low-dose methotrexate on eGFR and kidney adverse events: A randomized clinical trial. J Am Soc Nephrol 2021; 32:3197–3207. doi: 10.1681/ASN.2021050598

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  • 7.

    Levey AS, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150:604–612. doi: 10.7326/0003-4819-150-9-200905050-00006

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  • 8.

    Budancamanak M, et al. Protective effects of thymoquinone and methotrexate on the renal injury in collagen-induced arthritis. Arch Toxicol 2006; 80:768–776. doi: 10.1007/s00204-006-0094-0

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Impact of Low-Dose Methotrexate on Estimated Glomerular Filtration Rate

Bhavna Bhasin-Chhabra1 and Juan Carlos Q. Velez1
  • 1 Bhavna Bhasin-Chhabra, MD, is with the Division of Nephrology, Medical College of Wisconsin, Milwaukee. Juan Carlos Q. Velez, MD, is with the Department of Nephrology, Ochsner Clinic Foundation, New Orleans, LA, and Ochsner Clinical School, The University of Queensland, Brisbane, Australia.
Volume/Issue:
Volume 14: Issue 2
Publication Date:
01 Feb 2022
Page:
20
Restricted access

Methotrexate (MTX) has been used for treatment of connective tissue disorders, including rheumatoid arthritis. In much higher doses, MTX is used for various hematologic and oncologic disorders (1). Renal elimination accounts for 70%−90% of the clearance of MTX (2). High-dose intravenous MTX has the potential for causing kidney injury by crystal precipitation within the renal tubules (3, 4). In addition, oral MTX can potentially accumulate in patients with reduced kidney function and lead to toxic effects, such as myelosuppression and hepatotoxicity (5). However, although MTX is contraindicated in patients with
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