Gemcitabine, Paclitaxel, Doxorubicin in Metastatic or Unresectable Bladder Cancer With Decreased Kidney Function

Inclusion Criteria: * Histologically or cytologically confirmed transitional cell carcinoma (TCC) of the bladder, urethra, or upper urinary tract * Mixed TCC and variant histologies (i.e., small cell, squamous cell, adenocarcinoma, or sarcoma) allowed if present in \< 50% of the biopsy specimen * Patients must sign an informed consent indicating that they are aware of the investigational nature of this study, in keeping with the policies of the institution. * Measurable disease: may include radiographic detection of metastases in lymph nodes (\>= 1.5 cm) or liver or lung (\>= 1.0 cm) OR pelvic mass palpable on examination under anesthesia * Creatinine clearance \< 60 mL/min; no renal insufficiency that requires hemodialysis; no renal insufficiency that is reversible in patients with tumor confined to the primary site (i.e., that is potentially resectable with neoadjuvant chemotherapy) * Zubrod performance status 0-2 * Platelet count \> 100,000/mm\^3 * Absolute granulocyte count \> 1,500/mm\^3 * Bilirubin =\< 2.0 mg/dL * Aminotransferases (AST and ALT) =\< 2 times upper limit of normal * Left ventricular ejection fraction (LVEF) \> 40% OR normal electrocardiogram (EKG or ECG) and no history of cardiac disease * All patients must be evaluated in the Department of Genitourinary Medical Oncology at M. D. Anderson Cancer Center or participating CCOP center prior to signing informed consent. * No prior systemic chemotherapy including, adjuvant or neoadjuvant therapy * Prior intrav…