Effect of Mannitol Hydration as Renoprotective on Cisplatin Induced Nephrotoxicity (CIN) in Head and Neck Cancer Patients

Abstract

Background: Cisplatin is a cytostatic agent used as treatments in head and neck cancer patients. Nephrotoxicity is one of cisplatin major side effects. This study aimed to evaluate the renoprotective effect of mannitol-hydration administration in head and neck cancer patients who receive cisplatin chemotherapy. Methods: This was a cohort observational study to analyze the renal function of head and neck cancer patients who receives cisplatin before and after mannitol-hydration administration in IRNA Surgery and Soekardja Room of Chemotherapy at RSUD Dr. Soetomo Surabaya during June -September 2018. The data obtained were BUN, SCr, and eClCr Cockroft-Gault of each cycle. Result: A total of 52 patients were evaluated. The average value of creatinine serum, creatinine clearance, and BUN at each cycle were fluctuate. However, the average value of creatinine serum and BUN were within the normal limit. The result of statistical analysis using paired t-test in those parameters at each cycle were not statistically significant (p > 0,05) after mannitol administration except during first cycle to second cycle the SCr increased significantly and eClCr was decreased significantly (p-value 0,024; 0,006, CI 95% respectively ). At fourth cycle the eClCr also decreased significantly (p value 0,008, CI 95%). Conclusion: The renoprotective effect of mannitol in head and neck cancer patients who receive cisplatin chemotherapy is sufficiently adequate which can maintain the value of BUN and creatinine serum of patients at each cycle within the normal limit.