ReviewFrontiers in medicine2025
High-flux hemodialysis as rescue therapy for high-dose methotrexate toxicity: case series and clinical insights.
Review in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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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.
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Who cites it
3 citing papers in PubMed.
- Severe Methotrexate toxicity after ectopic pregnancy: a case report managed with continuous renal replacement therapy.Cancer chemotherapy and pharmacology · 2026Article
- Extracorporeal management of severe methotrexate toxicity and acute kidney injury in the absence of glucarpidase.BMJ case reports · 2025Article
- Case Report: Effective methotrexate removal by combined hemodialysis and polymeric resin hemoadsorption.Frontiers in nephrology · 2025Article
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
High-dose methotrexate (HD-MTX) toxicity represents a significant clinical challenge in oncology, commonly resulting in acute kidney injury (AKI), myelosuppression, and potentially life-threatening multiorgan failure. This case series describes three patients treated at Hospital de Base in São José do Rio Preto, Brazil, who developed HD-MTX-induced AKI following the administration of chemotherapy. Two patients had hematologic malignancies and one had osteosarcoma. All received conventional rescue therapies, including leucovorin and aggressive hydration, but demonstrated persistent elevation of serum methotrexate levels, necessitating the initiation of high-flux hemodialysis (HF-HD). The mean number of HF-HD sessions required was 5.3 ± 2.5, and the mean relative reduction in serum methotrexate concentration was 44.5 ± 19.1%. These findings suggest that HF-HD is an effective therapeutic option for HD-MTX toxicity management in settings where glucarpidase is not readily available, although repeated sessions may be required due to the observed rebound in serum methotrexate levels.
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