Q: Dear Sir /Madam, My father is stage 4 cancer, he has a mass of 6cm in the stomach, metastases 6-7 masses in liver, and some other parts. we were told that it was too late for chemothreapy and / or for operation. So while we are searching for alternatives, we found out DCA and wanted to try as our last chance. He is given very little short time. we already ordered the drug and would like to start using it as soon as possible but we have one important question: our father has aproblem with his kidneys as they are half functioning, this is one of the key reasons they would not apply chemothreapy to him since it can result to kidney failure on top of the cancer and spend his last days going to dialysis, so regarding using DCA is there any side effect concerning kidneys, would it result in kidney failure, what dosage should we use as he is at the last stage? Kurtulus. A: Dear Kurtulus, thank you for your question. We can confirm that DCA is safe to use with kidney failure. The main metabolism occurs in the liver and 99% of the drug metabolites are excreted through feces. We know patients that had severe chronic kidney disease and creatinine levels of 300-400 μmol/l (3.39-4.52 mg/dL) and have taken DCA without any problems. Regarding the question about renal toxicity. We haven't found scientific evidence that DCA could damage the kidneys: ''The drug does not alter renal concentrating ability or amino acid excretion. It slightly increases urinary lactate and pyruvate excretion, probably by inhibiting the specific tubular reabsorption of these anions. Of note, in the phase Ib clinical trial for GBM, the researchers have observed no other toxicity from DCA, including abnormalities in cardiac function, renal function, or liver tests.'' This means that there is no available evidence of Sodium dichloroacetate damaging the kidneys. In fact, there is one in vivo research which states that DCA pretreatment could even help protect the renal function from some chemotherapy toxicity when used in together (Dichloroacetate Prevents Cisplatin-Induced Nephrotoxicity without Compromising Cisplatin Anticancer Properties). *Important! This doesn't apply if the patient has Polycystic kidney disease. One should avoid DCA when suffering from this condition as DCA could in theory aggravate the condition. Regarding the question about dosing in such a situation. Your best option would be: •take 50 mg/kg I/V DCA injections. If intravenous DCA is not available, then take Sodium dichloroacetate by mouth, •take 12,5 mg/kg DCA powder for 14 days, make a 7 day break. If the patient tolerates the medication well without side effects, you can continue slowly try increasing the dosage to 20 mg/kg and 25 mg/kg after a while. Don't forget to take breaks (administrate DCA on 14 days on, 7 days off schedule), neuroprotective supplements and don't forget that DCA shouldn't be if severe liver failure is present.