A Systematic Review of Strategies to Prevent Cisplatin-Induced Nephrotoxicity

Abstract

Hydration is essential for all patients to prevent cisplatin-induced nephrotoxicity. Specifically, short-duration, low-volume, outpatient hydration with magnesium supplementation and mannitol forced diuresis (in select patients) represent best practice principles for the safe use of cisplatin. 2017;22:609-619 IMPLICATIONS FOR PRACTICE: The findings contained within this systematic review show that (a) hydration is essential for all patients to prevent cisplatin-induced nephrotoxicity, (b) short-duration, low-volume, outpatient hydration regimens appear to be safe and feasible, even in patients receiving intermediate- to high-dose cisplatin, (c) magnesium supplementation (8-16 milliequivalents) may limit cisplatin-induced nephrotoxicity, and (d) mannitol may be considered for high-dose cisplatin and/or patients with preexisting hypertension. These findings have broad implications for clinical practice and represent best practice principles for the prevention of cisplatin-induced nephrotoxicity.

Efficacy of Antioxidant Supplements on Prevention and Amelioration of Cisplatin-Induced Nephrotoxicity: A Systematic Review and Meta-analysis of Randomized Controlled Trials

“…Thus, it is essential to attenuate the acute manifestations and renal failure along with subclinical reduced kidney function. A recent systematic review was conducted to examine the efficacy of hydration therapy in the prevention or amelioration of CIN (9). However, the findings of the reviewed studies showed that hydration therapy was useful only in patients receiving high-dose CDDP and in some patients, over-diuresis resulted in dehydration (9).…”

“…A recent systematic review was conducted to examine the efficacy of hydration therapy in the prevention or amelioration of CIN (9). However, the findings of the reviewed studies showed that hydration therapy was useful only in patients receiving high-dose CDDP and in some patients, over-diuresis resulted in dehydration (9). Thus, currently, no ideal nephroprotective agent exists in clinical use for CIN treatment.…”

“…The current treatment strategy for cisplatin-induced nephrotoxicity (CIN) manifestations primarily includes supportive care with sodium chloride or bicarbonate volume expansion, metformin withdrawal, administration of various agents such as nonsteroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, angiotensin II-receptor blockers and statins, and reduced volume of contrast media (8). CIN can be ameliorated using oral hydration therapy (9) or magnesium supplementation (7); however, it is reversible and does not completely prevent CIN. Dialysis has been successfully implicated in the management of various features of CIN including uremia, metabolic disturbances, and hypervolemia; however, it does not play any role in the removal of accumulated cisplatin from renal tissue (10).…”

Using Global Criteria to Detect Malnutrition: Application in Disease States

“…Although not included in the GLIM criteria, the evaluation of fluid accumulation is included in the AND and ASPEN diagnostic characteristics, and the evaluation of fluid accumulation is an important aspect of nutrition assessment . Supportive intravenous fluids administered as part of a cancer care plan can impact weight and lead to variability in weights . The hydration status of cancer patients can vary based on oral fluid intake and fluid losses, and the influence of this should be considered as part of the weight loss evaluation.…”

The effect of rapid infusion of cisplatin on nephrotoxicity in patients with lung carcinoma

“…Numerous hydration schedules exist. A recent systematic review by Crona et al recommends hydration schedules with a short‐duration, a low hydration volume, and magnesium and potassium supplementation.…”