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Carfilzomib (kyprolis) Kidney Damage

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The myeloma chemotherapy carfilzomib (kyprolis) can damage kidney health. According to research, more than 80% of newly diagnosed myeloma patients present with kidney damage.

How can carfilzomib (kyprolis) damage kidney health?

The exact mechanisms by which carfilzomib may affect kidney function are not completely understood, but there are a few potential reasons:

  1. Protein Overload: Multiple myeloma itself can lead to the overproduction of abnormal proteins, which may accumulate in the kidneys and cause damage. Carfilzomib, by disrupting the function of proteasomes (cellular structures responsible for protein breakdown), may increase the load of protein debris in the body, including the kidneys.
  2. Decreased Blood Flow to the Kidneys: Carfilzomib can cause changes in blood pressure and blood flow. Reduced blood flow to the kidneys can impair their ability to filter waste products and maintain electrolyte balance, potentially leading to kidney dysfunction.
  3. Direct Toxicity: Some studies suggest that carfilzomib might have direct toxic effects on kidney cells, contributing to kidney damage.

Multiple myeloma can damage kidney function or chemotherapy can. The issue then is to figure out how to improve and possibly heal your kidney damage.

Non-conventional kidney therapies-

  1. Acupuncture:
    • Some studies suggest that acupuncture may help manage symptoms associated with chronic kidney disease (CKD) and improve quality of life. It’s important to find a qualified practitioner.
  2. Herbal Supplements:
    • Certain herbs are believed to have potential benefits for kidney health. For example, turmeric and ginger have anti-inflammatory properties. However, caution is necessary, as some herbs can interact with medications or exacerbate kidney problems.
  3. Mind-Body Practices:
    • Stress management techniques such as mindfulness meditation, yoga, and tai chi may help improve overall well-being and potentially have positive effects on kidney health. Stress reduction can contribute to better blood pressure control.
  4. Dietary Approaches:
    • Some non-conventional dietary approaches, such as the DASH (Dietary Approaches to Stop Hypertension) diet, emphasize fruits, vegetables, and low-fat dairy, which can be beneficial for kidney health by helping control blood pressure.
  5. Supplements:
    • Omega-3 fatty acids, found in fish oil, have been studied for their potential to reduce inflammation and improve cardiovascular health, which is important for kidney function. However, consult with a healthcare professional before taking any supplements.
  6. Probiotics:
    • Probiotics may have a role in supporting gut health, which can impact overall well-being. Some research suggests a potential link between gut health and kidney function, but more studies are needed.
  7. Aromatherapy:
    • Aromatherapy with essential oils may be used for relaxation and stress reduction. While there’s limited evidence for its direct impact on kidney health, it may contribute to overall well-being.
  8. Physical Activity:
    • Regular physical activity is associated with improved cardiovascular health, which indirectly benefits the kidneys. Exercise can help control blood pressure and manage diabetes, two factors that contribute to kidney disease.

In my experience as a myeloma survivor, oncology focuses on treating cancer at the expense of the rest of the patient. In the case of carfilzomib (kyprolis) kidney damage that means that the patient should look out for is/her kidney health.

Have you been diagnosed with multiple myeloma? Do you have kidney involvement as well? If you’d like to learn more about managing your kidney health, let me know David.PeopleBeatingCancer@gmail.com

Hang in there,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Carfilzomib-associated renal toxicity is common and unpredictable: a comprehensive analysis of 114 multiple myeloma patients

“Carfilzomib (CFZ) is a non-reversible proteasome inhibitor approved for the treatment of patients with relapsed and refractory myeloma (RRMM). Its use has been associated with cardiovascular toxicity but although recently a signal of clinically significant renal complications has also been identified, it is less extensively investigated.

We analyzed data of 114 consecutive patients with RRMM who received CFZ-based regimens. Renal complications not related to MM progression were observed in 19 (17%) patients;

  • thrombotic microangiopathy (TMA) was seen in 6 (5%) patients,
  • albuminuria >1 gr/day in 7 patients (6%)
  • and at least grade 3 acute kidney injury (AKI) which could not be otherwise explained in 6 patients (5%).

A total of 15 patients discontinued CFZ and dosing was reinitiated at a lower level in one patient with AKI. Albuminuria was associated with focal segmental glomerulosclerosis in the renal biopsy (performed in a total of 6 patients).

Renal complications during CFZ therapy are common, occur mostly early and are unpredictable. A potential effect of CFZ on the renal endothelium could be implicated in the pathogenesis of these complications and may also share common pathophysiology with cardiovascular effects of CFZ.

Efficacy of curcumin on prevention of drug-induced nephrotoxicity: A review of animal studies.

“Drug-induced nephrotoxicity is a frequent serious adverse effect, contributing to morbidity and increased healthcare utilization. Prevention or reversal is key. Curcumin has useful biological features that include antioxidant, anti-inflammatory, and anticancer properties. This review covers aspects of curcumin in relation to prevention of drug-induced nephrotoxicity: dosage and schedule, effect on kidney biomarkers and histological changes, and mechanisms of curcumin‘s protective effects. Despite success in some animal models, human studies and clinical administration of curcumin for nephroprotection remains limited due to difficulty in achieving therapeutic levels following oral administration and in determining the optimal dosing schedule. Lack of sufficient evidence from animal studies, coupled with low systemic bioavailability, continues to limit the utilization of curcumin in addressing and controlling drug-induced nephrotoxicity. Therefore, human studies are required to fully assess and validate the therapeutic potential of curcumin…”
“The renoprotective effect of curcumin has been evaluated in several experimental models including:
diabetic nephropathy,
chronic renal failure,
ischemia and reperfusion and
nephrotoxicity induced by compounds such as gentamicin, adriamycin, chloroquine, iron nitrilotriacetate, sodium fluoride, hexavalent chromium and cisplatin. It has been shown recently in a model of chronic renal failure that curcumin exerts a therapeutic effect; in fact it reverts not only systemic alterations but also glomerular hemodynamic changes. Another recent finding shows that the renoprotective effect of curcumin is associated to preservation of function and redox balance of mitochondria.

Carfilzomib-related acute kidney injury may be prevented by N-acetyl-L-cysteine

“Carfilzomib is a second-generation epoxyketone proteasome inhibitor that is approved for treatment of relapsed and refractory multiple myeloma. Phase 2 trials have reported that 25% of treated patients have renal adverse effects. Pre-renal/vasoconstriction-related insult from this chemotherapy agent has been documented. We describe a case of a 78-year-old man with refractory multiple myeloma with acute kidney injury associated with carfilzomib treatment. We show that use of N-acetyl-l-cysteine in our patient partially mitigated the renal injury upon re-challenge. This case report hypothesizes that acute renal injury from carfilzomib is caused by vasoconstriction of the renal vessels, which may be prevented by N-acetyl-l-cysteine…

What to Know About Supplements and Your Kidneys

“Getting the right amount of nutrients is an essential part of your diet and is vital for your health. Nutrients supply your body what it needs to properly function daily, such as a boost in energy, improvement in muscles and body tissue, and even help fighting against infections. The right kind of nutrients will also help you remain at a healthy weight…”

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