Die 131-Jod-Hippuranclearance zur Erfassung der nephrotoxischen Wirkung von cis-Dichlorodiamino-Platin (II) (cis-Platin, cis-DDP)

Abstract

In 25 patients, who received repeated doses of cis-DDP, we determined iodo-131-hippurate-clearance, creatinine clearance and serum creatinine to assess the nephrotoxic effect induced by cis-DDP. A highly significant decrease in the iodo-131-hippurate-clearance was found between the first and the following cycles. There was no significant change in serum creatinine and creatinine clearance however. The radio-hippurate-clearance showed a clinically not important reduction during several cytotoxic courses in 15/25 patients (60%). A clinically relevant impairment of the radio-hippurate-clearance occurred in 8/25 patients (32%), mainly before the third and fifth cytotoxic cycle. In two patients this clearance did not alter or was even rising. In 12 cases a diminuation of the iodo-131-hippurate-clearance was observed, which in only 5 cases correlated to a decreased creatinine clearance and in only two cases to an elevated serum creatinine. Therefore, we consider neither creatinine nor creatinine clearance nor the combination of both parameters to be appropriate to assess tubular nephropathy induced by cis-DDP. Radio-hippurate-clearance should play a superior role deciding on treatment stop or dose reduction of cis-DDP. The regression of cis-DDP-induced nephropathy was not evaluated.

131I-Orthoiodohippurate Clearance in the Detection of Cisplatin Nephrotoxicity

“…An efficient method of detecting tubular damage is the measurement of renal tubular clearance (17) which requires the exclusive renal elimination of the clearance substances. Orthoiodohippuric acid (OHA) is mainly secreted by the tubuli and is consequently a suitable indicator of normal tubular function.…”