Acute and chronic effects of cisplatin therapy on renal magnesium homeostasis

Ariceta, Gema; Rodríguez‐Soriano, Juan; Vallo, Alfredo; Navajas, Aurora

doi:10.1002/(sici)1096-911x(199701)28:1<35::aid-mpo7>3.0.co;2-u

Cited by 76 publications

(55 citation statements)

References 35 publications

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“…17 Other patient series report hypomagnesaemia in up to 88% of patients receiving cisplatin. 14,18,19 Hypomagnesaemia can be life-threatening; for example, Bashir et al report a patient with cisplatininduced hypomagnesaemia who suffered brief asystole. 20 The degree of hypomagnesaemia is related to the cumulative cisplatin dose.…”

Section: Discussionmentioning

confidence: 94%

Serum potassium, calcium and magnesium in patients receiving ESHAP chemotherapy for relapsed lymphomas

Zekri

Nl²,

Evans³

et al. 2009

JRCPE

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Etoposide, methylprednisolone, cytarabine and cisplatin (ESHAP) is one of the mostly widely used chemotherapy regimens for patients with relapsed lymphomas. Cisplatin administration is commonly associated with electrolyte imbalance. Careful monitoring of renal function and serum electrolytes is therefore essential in this setting. Aims: To review the practice of electrolyte monitoring -potassium (K), calcium (Ca) and magnesium (Mg) -in patients receiving ESHAP and the frequency and severity of abnormalities and their management. Methods: Twenty-one consecutive patients received ESHAP. The medical records of 16 patients were retrievable and reviewed retrospectively. Results of serum K, Ca and Mg were collected prior to and after cycles 1, 2 and 3 of ESHAP, if measured. Results: Serum K levels prior to every cycle did not show any noticeable change. The means were 4.42, 4.34 and 4.43 mmol/l before cycles 1, 2 and 3, respectively. In one patient hypokalaemia was severe, refractory and symptomatic when preceded by hypomagnesaemia. Serum-adjusted calcium levels showed only minimal reduction. The means were 2.46, 2.40 and 2.38 mmol/l before cycles 1, 2 and 3 respectively. Mean serum Mg levels prior to every cycle showed progressive reduction; 0.84, 0.75 and 0.67 mmol/l before cycles 1, 2 and 3, respectively. This was associated with a progressive increase in the amount of required Mg supplementation. Serum K, Ca and Mg was measured prior to 100%, 67% and 35% of administered cycles, respectively. Conclusion: In patients receiving ESHAP, hypokalaemia can occasionally be seen, especially if preceded by hypomagnesaemia. Mild cumulative hypocalcaemia is recognised. Hypomagnesaemia is a progressive complication and physicians need be aware of its importance.

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Section: Discussionmentioning

confidence: 94%

Serum potassium, calcium and magnesium in patients receiving ESHAP chemotherapy for relapsed lymphomas

Zekri

Nl²,

Evans³

et al. 2009

JRCPE

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“…Algunos estudios han apreciado hipomagnesemia hasta en el 90% de los pacientes en tratamiento con cisplatino. La presencia de esta toxicidad está en relación a la dosis acumulada; se ha establecido que una dosis acumulada de 300 mg/m 2 de cisplatino es la dosis míni-ma para producir hipomagnesemia en una población pediátrica 4 . A pesar de que el mecanismo exacto de la hipomagnesemia inducida por cisplatino no está del todo aclarado 3 , se considera que el cisplatino interfiere en la absorción renal de magnesio ya que los pacientes con hipomagnesemia presentan cantidades excretadas de magnesio en orina aumentadas.…”

Section: Discussionunclassified

Alucinaciones visuales y dolor inusual en relación a hipomagnesemia en un paciente con cáncer avanzado

Bosch-Barrera

Urdiroz

Centeno

2010

Anales Sis San Navarra

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REsUMEnLa hipomagnesemia se ha relacionado con dosis acumuladas altas de cisplatino y su presentación clíni-ca se caracteriza por alteraciones neuromusculares y cardiovasculares.Presentamos el caso de un paciente con cáncer avanzado que había recibido varias líneas de tratamiento de quimioterapia y recibía tratamiento analgésico opioide. Durante su estancia en el hospital presentó alucinaciones visuales y un intenso e inexplicado dolor en el hombro. La sintomatología revirtió tras la normalización de los niveles de magnesio en sangre, que eran bajos. Consideramos que los niveles séricos de magnesio deberían monitorizarse en los pacientes oncológicos con dolor inusual o síntomas neurológicos o psiquiátricos no explicables.Palabras clave. Neurotoxicidad. Opiáceo. Hipomagnesemia. Alucinación. Dolor. aBstRactHypomagnesemia has been related to high accumulated doses of cisplatin, and its clinical presence is characterized by neuromuscular and cardiovascular alterations.We present the case of an advanced cancer patient who had received successive lines of chemotherapy and who was receiving opioid treatment for cancer pain. During his hospital stay, he experienced visual hallucinations and very intense, unexplained pain in one shoulder. Symptoms reverted with the normalization of his plasma magnesium levels, which were low. We consider that plasma magnesium levels should be monitored in oncology patients with neurological or psychiatric symptoms or with unusual pain.

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“…Clinical and experimental studies have shown that CDDP interferes with magnesium transport, predominantly in the distal tubules [17][18][19]. Hypomagnesaemia caused by CDDP administration may persist for a few years after the end of therapy [20][21][22][23] and, in 1/3 to 2/3 children, may become permanent [21,24].…”

Section: Clinical Aspects Of Cisplatin Nephrotoxicitymentioning

confidence: 99%