Which intervention from the following is listed as a possible measure to manage nephrotoxicity in chemotherapy patients?

Which intervention from the following is listed as a possible measure to manage nephrotoxicity in chemotherapy patients?

• A. Administering sodium bicarbonate IV
• B. Administering potassium chloride IV
• C. Administering insulin
• D. Administering chemotherapy dose increase

Answer: (A)

Alkalinizing the urine is a key strategy to prevent kidney injury when high-dose methotrexate is used. Administering sodium bicarbonate IV raises urine pH, making MTX more soluble and less likely to precipitate in the renal tubules. This reduces crystalluria and helps the kidneys clear the drug more effectively, lowering the risk of nephrotoxicity. In practice, this approach is part of a broader protective regimen that includes aggressive IV hydration and leucovorin rescue to shield normal cells from MTX toxicity. The other choices don’t provide nephroprotection in this context: potassium chloride is used to correct potassium imbalances, not to prevent MTX-related kidney injury; insulin is for managing glucose or potassium in specific situations; increasing the chemotherapy dose would likely worsen nephrotoxicity rather than prevent it.

Alkalinizing the urine is a key strategy to prevent kidney injury when high-dose methotrexate is used. Administering sodium bicarbonate IV raises urine pH, making MTX more soluble and less likely to precipitate in the renal tubules. This reduces crystalluria and helps the kidneys clear the drug more effectively, lowering the risk of nephrotoxicity. In practice, this approach is part of a broader protective regimen that includes aggressive IV hydration and leucovorin rescue to shield normal cells from MTX toxicity.

The other choices don’t provide nephroprotection in this context: potassium chloride is used to correct potassium imbalances, not to prevent MTX-related kidney injury; insulin is for managing glucose or potassium in specific situations; increasing the chemotherapy dose would likely worsen nephrotoxicity rather than prevent it.