Standard Versus Reduced Hydration to Improve Elimination of High-Dose Methotrexate in Pediatric Patients: A Controlled Crossover Trial.

Background: Hydration and urine alkalinization are the mainstays for the prevention of methotrexate-induced nephrotoxicity. Current oncology protocols recommend pediatric patients who are administered high-dose methotrexate (HDMTX) to be aggressively hydrated with an alkaline solution, which may lead to overhydration. This pilot study sought to determine whether reduced posthydration results in a shorter time to methotrexate elimination without increasing adverse effects.