tokens: The clinician should be alert to recognize several factors that may maximize renal dysfunction and contribute to the increased incidence of nephrotoxicity associated with these drugs , such as intravascular volume depletion , the associated use of nonchemotherapeutic nephrotoxic drugs ( analgesics , antibiotics , proton pump inhibitors , and bone - targeted therapies ) , radiographic ionic contrast media or radiation therapy , urinary tract obstruction , and intrinsic renal disease .