Association of cisplatin nephrotoxicity with patient characteristics and cisplatin administration methods

Abstract

(1) While several factors correlated with cisplatin nephrotoxicity, most of the observed nephrotoxicity was not explained by the variables identified. (2) While most patients received intravenous hydration, patients receiving high hydration volumes did not have significantly less nephrotoxicity than patients receiving lower hydration volumes: (3) Of the variables identified, serum albumin, metoclopramide and phenytoin may have affected nephrotoxicity by altering cisplatin uptake into or distribution within the kidney.

Weekly high-dose cisplatin is a feasible treatment option: analysis on prognostic factors for toxicity in 400 patients

“…Another strong predisposing factor for renal toxicity was hypoalbuminaemia. This has also been described for patients receiving conventional cisplatin treatment (Stewart et al, 1997). Various studies have demonstrated that cisplatin-induced nephrotoxicity is related to the peak plasma concentration and/or the area under the plasma concentration -time curve of nonprotein bound cisplatin (Reece et al, 1987;Nagai et al, 1996;Nagai and Ogata, 1997).…”

“…Although it cannot be excluded that smoking was associated with nephrotoxicity through coexisting smoking-related cardiovascular disease, other indicators for cardiovascular disease such as hypertension and diminished baseline creatinine clearance were not identified as risk factors for cisplatin-induced nephrotoxicity. Furthermore, there was no association between nephrotoxicity and a history of hypertension, cardiovascular disease or diabetes mellitus in 425 patients treated with conventional cisplatin chemotherapy (Stewart et al, 1997). Another strong predisposing factor for renal toxicity was hypoalbuminaemia.…”

Nephroprotection by Theophylline in Patients with Cisplatin Chemotherapy

“…Besides adequate hydration before and during cisplatin administration and afterward in combination with an osmotic diuretic such as mannitol (the current standard method), e.g., prolongation of the infusion time of cisplatin (e.g., 6 h instead of 2 h), dose fractionation over several days, the use of a chronomodulated schedule, and the use of nephroprotective agents such as organic thiosulfate compounds have been investigated in this setting (18,(27)(28)(29)(30)(31). However, in general practice, a single-dose application of cisplatin as a 1-h infusion remains the common standard, and only dose fractionation over several days is being used in some cancer types (2,3).…”

Risk Factors Associated with Cisplatin-Induced Nephrotoxicity in Patients with Advanced Lung Cancer

“…In accordance with a previous study, 17) we adopted an increase in SCr as a measure of nephrotoxicity. The rationale for considering screening for early-stage nephrotoxicity includes detection of mild renal dysfunction due to aging.…”