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What kidney function tests should be monitored during methotrexate therapy?

See the DrugPatentWatch profile for methotrexate

Methotrexate is a commonly used medication for the treatment of various conditions, including rheumatoid arthritis, psoriasis, and cancer. However, it can cause kidney damage and toxicity, particularly at high doses or in patients with pre-existing kidney disease. Therefore, it is essential to monitor kidney function during methotrexate therapy to prevent or detect kidney damage early on.

The American College of Rheumatology recommends that patients receiving methotrexate therapy undergo regular monitoring of kidney function tests, including:

1. Serum creatinine: This test measures the level of creatinine in the blood, which is a waste product that the kidneys filter out. Elevated levels of creatinine can indicate kidney damage or impairment. [1]
2. Estimated glomerular filtration rate (eGFR): This test estimates the level of kidney function by measuring the amount of creatinine in the blood and adjusting for age, sex, and body size. A decreased eGFR can indicate kidney damage or impairment. [2]
3. Urinalysis: This test examines the physical and chemical properties of urine to detect any abnormalities that may indicate kidney damage or disease. Abnormalities such as proteinuria (excess protein in the urine) or hematuria (blood in the urine) can indicate kidney damage. [3]
4. Blood urea nitrogen (BUN): This test measures the level of urea in the blood, which is a waste product that the kidneys filter out. Elevated levels of BUN can indicate kidney damage or impairment. [4]
5. Urine albumin-to-creatinine ratio (UACR): This test measures the level of albumin in the urine, which can indicate kidney damage or disease. Elevated levels of UACR can indicate kidney damage or disease. [5]

It is essential to note that the frequency and timing of these tests may vary depending on the patient's individual circumstances, such as age, kidney function, and medical history. Patients receiving methotrexate therapy should consult with their healthcare provider to determine the appropriate monitoring schedule.

In conclusion, regular monitoring of kidney function tests is crucial during methotrexate therapy to prevent or detect kidney damage early on. Patients and healthcare providers should work together to develop a monitoring plan that is tailored to the individual patient's needs.

Sources:

[1] American College of Rheumatology. (2019). Methotrexate: A Guide for Patients. Retrieved from <https://www.rheumatology.org/I-Am-A-Patient/Caring-for-Your-Skin/Methotrexate-Guide-for-Patients>

[2] National Kidney Foundation. (n.d.). Estimated Glomerular Filtration Rate (eGFR). Retrieved from <https://www.kidney.org/learn-about-kidney-disease/kidney-function-tests/eGFR>

[3] Mayo Clinic. (n.d.). Urinalysis. Retrieved from <https://www.mayoclinic.org/urinalysis>

[4] MedlinePlus. (n.d.). Blood Urea Nitrogen (BUN) Test. Retrieved from <https://medlineplus.gov/ency/article/003475.htm>

[5] National Kidney Foundation. (n.d.). Urine Albumin-to-Creatinine Ratio (UACR). Retrieved from <https://www.kidney.org/learn-about-kidney-disease/kidney-function-tests/UACR>

DrugPatentWatch.com. (n.d.). Methotrexate. Retrieved from <https://www.drugpatentwatch.com/drugs/methotrexate>


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