Evidence map›Paper›PMID 39525565›Full record

ArticleInternational journal of nephrology and renovascular disease2024

Serum Methotrexate Level Predicts Acute Kidney Injury After High-Dose Methotrexate: A Case Report and Single-Center Experience.

Pao-Wen Yen, Hsing-Yu Lin, Chien-Chih Wu, Tai-Chung Huang, Shang-Ju Wu, Szu-Yu Pan, Kuan-Yu Hung

Abstract read
In one paragraph

Article in International journal of nephrology and renovascular disease, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Pao-Wen YenDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
Hsing-Yu LinDepartment of Pharmacy, National Taiwan University Hospital, Taipei City, Taiwan.
Chien-Chih WuDepartment of Pharmacy, National Taiwan University Hospital, Taipei City, Taiwan.ORCID 0000-0002-9517-2176
Tai-Chung HuangDivision of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
Shang-Ju WuDivision of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
Szu-Yu PanDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
Kuan-Yu HungDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acute kidney injury (AKI) is a serious complication following high-dose methotrexate (HD-MTX) treatment, despite established preventive measures. This study presents a case report and a retrospective review of patients treated with HD-MTX, aiming to identify risk factors for AKI and propose a modified treatment protocol. Methods: We report a case of a 43-year-old man with diffuse large B-cell lymphoma who developed severe AKI after HD-MTX therapy. Additionally, a retrospective review of 70 patients receiving HD-MTX at our institution was conducted to identify predictors of AKI. Serum methotrexate levels were analyzed to determine their significance in predicting AKI. Results: The index patient developed methotrexate intoxication and severe AKI despite receiving standard prophylactic measures, requiring temporary hemodialysis. The retrospective review identified serum methotrexate levels as a significant predictor of AKI (OR 11.84, 95% CI: 2.62-53.53, p = 0.001). Higher initial serum methotrexate levels correlated with the development of AKI. Conclusion: Timely measurement of serum methotrexate levels is crucial in managing and preventing AKI in patients undergoing HD-MTX therapy. Based on our findings, we propose a modified HD-MTX treatment protocol to reduce the incidence of AKI. This includes earlier serum methotrexate level monitoring and adjustments in urine alkalization and leucovorin dosing strategies.

Indexed as

acute kidney injurymethotrexate

Identifiers

PMID39525565
PMCPMC11549911

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