Acute kidney injury caused by high dose methotrexate is a severe and fatal toxicity. Carboxypeptidase is an fda-approved drug used to treat kidney dysfunction caused by high doses of methotrexate. In this paper, the application of carboxypeptidase in the treatment of acute kidney injury caused by high-dose methotrexate and the related contents of methotrexate clearance delay patients were proposed, which involved the identification of drug population and drug usage.

The guidelines eventually came to a consensus that carboxypeptidase was strongly recommended for high-dose methotrexate, and that implementation of the guidelines would help reduce the life-threatening effects of high-dose methotrexate.

The clinical guidelines were developed by a team of senior clinicians, including oncologists, nephrologists, pharmacists, clinical pharmacologists, and nurses, with the support of the national cancer institute (NCI).