Protective effect of selenium on cisplatin induced nephrotoxicity: A double-blind controlled randomized clinical trial

Abstract

Background: Renal injury is common following cisplatin infusion. Some agents have been used to attenuate cisplatin nephrotoxicity. However, except hydration, none of them has been proved to be effective. Objective: In this study selenium as an antioxidant supplement was tested on cisplatin induced renal injury. Patients and Methods: 122 cancerous patients (85 male and 37 female; age range of 14 to 82 years old) were enrolled to receive chemotherapy regimens consisting cisplatin. They were allocated into two groups using a random number list . Investigators, patients and analyzers all, were blinded in allocation by using sealed opaque envelopes. Intervention group received a single 400 mcg selenium tablet and patients in control group took a placebo tablet which was similar with selenium preparation in color, weight, shape and taste. Primary end points were an increase in plasma creatinine above 1.5 mg/dl in men and 1.4mg/dl in women, or increase of plasma creatinine more than 50% from baseline or urine flow rate less than 0.5 ml/kg/h. Creatinine level was measured initially and on the 5th day after cisplatin therapy. Results: There was no difference in cumulative dose of cisplatin between the groups (p=0.54). There were not evidences of acute renal failure (ARF) in cases. While, among placebo group, 7 patients had criteria of acute kidney injury. Conclusions: selenium could probably prevent cisplatin-induced acute kidney injury, when it is added to hydration therapy in cancerous patients. Implication for health policy/practice/research/medical education:Renal injury is common following cisplatin infusion. Selenium could probably prevent cisplatin-induced acute renal failure when it is added to hydration in cancerous patients.Please cite this paper as: Ghorbani A, Omidvar B, Parsi A. Protective effect of selenium on cisplatin induced nephrotoxicity: A double-blind controlled randomized clinical trial. J Nephropathology. 2013; 2(2): 129-134.

C-Phycocyanin attenuates cisplatin-induced nephrotoxicity in mice

“…4 We concluded that gender difference of cisplatin renal toxicity was related to the reninangiotensin system receptors in the kidneys. [4][5][6][7][8][9] Moreover, we recently found that vitamin C, vitamin E, or losartan have no ameliorative effects against cisplatin-kidney toxicity in presence of estrogen in ovariectomized rat model of cisplatin toxicity, 10 which is in agreement with our previous findings too. Hence, it is well established that there is a gender difference in the cisplatin renal toxicity in rat model.…”

“…Hence, it is well established that there is a gender difference in the cisplatin renal toxicity in rat model. Indeed, it is well recognized that some conditions that lead to chronic kidney diseases are sex related too; [5][6][7][8][9][11][12][13] however, few studies published regarding gender difference in cisplatin renal toxicity . However, there still needs to be more investigations, mechanisms take part in cisplatin renal toxicity especially on gender difference.…”

Pu-erh Tea Powder Preventive Effects on Cisplatin-Induced Liver Oxidative Damage in Wistar Rats

“…Johns et al (2012) concluded that cisplatin therapy had been shown to induce high levels of lipid peroxidation in lung cancer patients and could be assessed from the 8-isoprostane marker in overnight urine, with or without volume correction (Johns et al, 2012). Thus, the administration of antioxidants such as vitamin C, vitamin E, Silymarin, selenium, and so on before the administration of CDDP has been used to protect against kidney and liver toxicities (Ajith et al, 2009;Abdelmeguid et al, 2010;Ghorbani et al, 2013).…”

Selenium – a fascinating antioxidant of protective properties

“…They found that acute kidney failure occurred in 11.5% of patients treated with cisplatin, whereas in those pretreated with a single selenium tablet (400 mcg), no such cases were observed. 57 Similarly, Mix et al observed some protective influence of selenium treatment (selenomethionine, 1 week before as well as during therapy) in patients with inoperable, stage III non-small cell lung cancer undergoing concurrent chemoradiation (radiation, paclitaxel and cisplatin). 23 …”