Abstract
Methotrexate (MTX)-associated acute kidney injury (AKI) occurs in 3% to 60% of patients at some point during treatment.1,2 The standard of care for MTX dose derivation and postdose monitoring centers around serum creatinine level as a surrogate for glomerular filtration rate (GFR).3 As the terminal byproduct of skeletal muscle metabolism, nonrenal determinants, including altered muscle mass, deconditioning, and malnutrition, can decrease the accuracy of serum creatinine-based GFR estimation in patients with cancer.
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