Advances in Managing Acute Kidney Injury: Improving Outcomes for Patients Treated with High-Dose Methotrexate

A Two-Part Case-Based Activity for Oncology Advanced Practitioners

High-dose methotrexate (HDMTX) continues to be used in several treatment regimens for patients with solid tumors and hematologic malignancies. Despite appropriate supportive care measures during its administration, patients receiving HDMTX are at risk of developing acute kidney injury (AKI) due to delayed clearance. Consensus guidelines were developed to help the health-care team optimize the treatment of HDMTX-induced AKI and understand at which timepoints glucarpidase is most effective. In this two-part video series, three advanced practice providers discuss strategies to monitor patients treated with HDMTX for development of AKI, the patient and disease characteristics that trigger treatment with glucarpidase, and best practices for treating HDMTX-induced AKI safely and effectively based on available evidence and guidelines.

Learning Objectives:

  • Plan strategies to monitor patients treated with HDMTX for development of AKI
  • Identify patient and disease characteristics that trigger treatment with glucarpidase
  • Formulate plans to treat AKI caused by HDMTX safely and effectively based on best available evidence and recent guidelines

To learn more about this topic, visit Optimizing the Treatment of Acute Kidney Injury Caused by High-Dose Methotrexate: Integrating New Guidelines to Improve Patient Care

Case Study 1: HDMTX-Induced AKI in Osteosarcoma

Using the case of a 31-year-old female patient undergoing treatment for osteosarcoma, Nancy Nix, PharmD, BCPS, BCOP, and Kristi Posey, PA, discuss risk factors for acute kidney injury following high-dose methotrexate (HDMTX) treatment, as well as the importance of pretreatment patient counseling and working as a team to quickly identify and treat delayed HDMTX clearance. They also take a deep dive into the consensus guidelines on the use of glucarpidase rescue and how to correlate clinical findings and lab values to increase the timeliness of treatment decision making.

Posted: September 10, 2019 / Expires: September 10, 2020

0.5 Credit

Estimated time to complete: 30 minutes

Access the Activity for CE Credit*
   
Watch Video Without Claiming Credit

* This activity is supported by an educational grant from BTG International Inc.


Case Study 2: HDMTX-Induced AKI in CNS Lymphoma

Nancy Nix, PharmD, BCPS, BCOP, and Haleigh Mistry, MS, PA-C, discuss the case of a 58-year-old female patient receiving high-dose methotrexate (HDMTX) as part of treatment for central nervous system lymphoma. Together, they review contraindications to HDMTX; the importance of adequate hydration and urine alkalinization prior to initiating therapy; the mechanisms of action of MTX, glucarpidase, and leucovorin; as well as recent studies demonstrating improved outcomes, decreased mortality, and shorter length of hospital stay among patients receiving glucarpidase for HDMTX-induced acute kidney injury.

Posted: September 10, 2019 / Expires: September 10, 2020

0.5 Credit

Estimated time to complete: 30 minutes

Access the Activity for CE Credit*
   
Watch Video Without Claiming Credit

* This activity is supported by an educational grant from BTG International Inc.


 
These activities, certified for CME/CE/CPE credit, are jointly provided by

Annenberg Logo Harborside Press Logo

Copyright © 2010-2019 Harborside Press, LLC All rights reserved.               
Home | Current Issue | Previous Issue | Submissions | About JADPRO | Advertising | Privacy Policy | Contact | Copyright Notice/Disclaimer | Subscribe
Bot trap - Don't go here
By continuing to browse this site you permit us and our partners to place identification cookies on your browser and agree to our use of cookies to identify you for marketing. Read our Privacy Policy to learn more.