Comparison of Renal Functions Evaluated by Measured Glomerular Filtration Rate in Patients Treated With Cisplatin, Carboplatin, and Oxaliplatin

Abstract

Introduction: In cancer chemotherapy platinum drugs do cause damage to the normal cells and as a result, many physiological functions are derailed. Renal function as measured by measured glomerular filtration rate (mGFR) plays a large role in drug dosing on the basis of the maximum tolerated dose, which is the highest dose that may be administered without unacceptable toxicity, to maximize anticancer efficacy.Objective: The objective of the study was to compare the toxic effect of platinum drugs on renal function as measured by mGFR in patients with malignancy and to study the difference in the magnitude of nephrotoxicity by these drugs.Methodology: The study was conducted in the Department of Physiology in close collaboration with the Department of Radiotherapy at a tertiary care centre in Western Rajasthan, India. 150 patients suffering from different malignances undergoing treatment with cisplatin, carboplatin, and oxaliplatin were examined for their renal function as measured by mGFR using 99m Tc-diethylene triamine pentaacetic acid ( 99m Tc-DTPA) and were compared with 50 subjects of control group.Results: In the cisplatin group there was a gradual fall of GFR from 85.49 ml/min/1.73sqm to 58.09ml/min/1.73sqm at cycle II. In the carboplatin group it was 84.86ml/min/1.73sqm at baseline whereas cycle II was 75.5 ml/min/1.73sqm with SD ± 16.49. mGFR fell significantly (p<0.0001) in cisplatin and carboplatin groups but not in the cohort of patients who received oxaliplatin. The GFR reduction continued from the baseline to cycle I and then cycle II in cisplatin and carboplatin groups.Conclusion: Nephrotoxicity is a major side effect of platin drugs and further studies should be done to establish their optimal dose in relation to renal function and minimize toxicity by trying various cytoprotective agents.