ABSTRACT
With the introduction of radionuclide therapies, the probability of toxicity has increased in critical organs such as kidney and bone marrow. Although these toxicity rates are relatively low in targeted therapies such as radionuclide therapy, a number of organs, especially the kidneys, are affected by radiation. Radionuclide therapies that led to the major risk for renal toxicity are neuroendocrine tumor treatment with beta-emitting radioisotopes (Lu-177 and Y-90) labeled with [DOTA0, Tyr3]-octreotate (DOTATATE), and prostate cancer treatment with alpha or beta emitters, such as Lu-177 or Ac-225, labeled with prostate specific membrane antigen. The intense uptake and prolonged retention of these radioactive molecules in the kidneys raise concerns about the potential toxicity of kidneys by radiation that puts therapeutic efficacy at risk. In this review, nephrotoxicity resulting from radionuclide therapy, particularly Lu-177 and Y-90, and therapeutic options to reduce the toxicity are discussed.
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