Anticancer Medications and Sodium Dysmetabolism.
Anticancer medications
dyselectrolytaemia
hypernatraemia
hyponatraemia
syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
Journal
European endocrinology
ISSN: 1758-3780
Titre abrégé: Eur Endocrinol
Pays: England
ID NLM: 101574781
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
16
04
2020
accepted:
04
05
2020
entrez:
29
10
2020
pubmed:
30
10
2020
medline:
30
10
2020
Statut:
ppublish
Résumé
Therapeutic advances have revolutionised cancer treatment over the last two decades, but despite improved survival and outcomes, adverse effects to anticancer therapy such as dyselectrolytaemias do occur and need to be managed appropriately. This review explores essential aspects of sodium homeostasis in cancer with a focus on alterations arising from anticancer medications. Sodium and water balance are tightly regulated by close interplay of stimuli arising from hypothalamic osmoreceptors, arterial and atrial baroreceptors and the renal juxtaglomerular apparatus. This delicate balance can be disrupted by cancer itself, as well as the medications used to treat it. Some of the conventional chemotherapeutics, such as alkylating agents and platinum-based drugs, can cause hyponatraemia and, on rare occasions, hypernatraemia. Other conventional agents such as vinca alkaloids, as well as newer targeted cancer therapies including small molecule inhibitors and monoclonal antibodies, can cause hyponatraemia, usually as a result of inappropriate antidiuretic hormone secretion. Hyponatraemia can also sometimes occur secondarily to drug-induced hypocortisolism or salt-wasting syndromes. Another atypical but distinct mechanism for hyponatraemia is via pituitary dysfunction induced by immune checkpoint inhibitors. Hypernatraemia is uncommon and occasionally ensues as a result of drug-induced nephrogenic diabetes insipidus. Identification of the aetiology and appropriate management of these conditions, in addition to averting treatment-related problems, can be lifesaving in critical situations.
Identifiants
pubmed: 33117443
doi: 10.17925/EE.2020.16.2.122
pmc: PMC7572166
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
122-130Informations de copyright
© Touch Medical Media 2020.
Déclaration de conflit d'intérêts
Disclosures: Aishwarya Krishnamurthy, Saptarshi Bhattacharya, Tejal Lathia, Viny Kantroo, Sanjay Kalra and Deep Dutta have no financial or non-financial relationships or activities to declare in relation to this article. Sanjay Kalra and Deep Dutta are members of the journal’s Editorial Board.
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