Which therapeutic measure listed is used to address nephrotoxicity from chemotherapy?

• A. Administering sodium bicarbonate IV
• B. Administering testosterone
• C. Administering antihistamines
• D. Administering NSAIDs

Answer: (A)

Protecting kidney function during chemotherapy often involves preventing drug-related precipitation in the renal tubules. Some chemotherapy regimens, notably high-dose methotrexate, can cause nephrotoxicity if the drug or its metabolites precipitate in acidic urine. Administering intravenous sodium bicarbonate alkalinizes the urine, raising the pH to about 7 or higher, which keeps methotrexate soluble and promotes its excretion. This urine alkalinization is typically used together with aggressive IV hydration and other MTX-protective measures. The other options don’t address this protective mechanism: testosterone has no nephroprotective role, antihistamines aren’t protective for kidneys, and NSAIDs can impair kidney function and worsen nephrotoxicity.