Rates of Renal Toxicity in Cancer Patients Receiving Cisplatin With and Without Mannitol

Abstract

When limited quantities of mannitol are available, it should preferentially be given to patients at particularly high risk of nephrotoxicity. Our analysis suggests that those patients receiving the dosing schedule of 100 mg/m cisplatin every 3 weeks and those with hypertension are at the greatest risk of nephrotoxicity and would benefit from the addition of mannitol.

Predictive risk factors of acute kidney injury after cytoreductive surgery and cisplatin-based hyperthermic intra-peritoneal chemotherapy for ovarian peritoneal carcinomatosis

“…Another study, with 390 patients admitted to a medical intensive care unit for septic shock, also showed an association between anti-hypertensive treatment and the development of acute kidney injury 22. Concerning hypertension, a recent study involving cancer patients receiving cisplatin with or without mannitol as nephroprotectant showed that patients with a previous history of hypertension had a higher likelihood of developing nephrotoxicity 23. Another workgroup constructed a predictive model for the occurrence of acute kidney injury after the first course of cisplatin, in which previous history of hypertension was included 24.…”

Prävention der akuten Nierenschädigung beim kritisch kranken Patienten

“…B. mit Iohexol für unabdingbar erachten [30]. Bei wiederholten Cisplatindosen von >100 mg/m 2 ist die Gabe von Mannitol mit einem verminderten Auftreten von AKI assoziiert [55]. Eine Präventionsmaßnahme für Patienten mit einem hohen Risiko für ein Tumorlysesyndrom ist die Gabe von Xanthinoxidaseinhibitoren [74].…”

A retrospective evaluation of furosemide and mannitol for prevention of cisplatin-induced nephrotoxicity

“…Clinical manifestations of cisplatin‐induced nephrotoxicity include decreased glomerular filtration, increased serum creatinine and reduced levels of serum magnesium and potassium . Greater risk has been reported with increased dose and frequency of cisplatin administration . Mechanistically, cisplatin‐associated nephrotoxicity has been attributed to the activation of complex signalling pathways that lead to injury and death of renal tubule cells .…”

“…[7][8][9] Greater risk has been reported with increased dose and frequency of cisplatin administration. 10 Mechanistically, cisplatin-associated nephrotoxicity has been attributed to the activation of complex signalling pathways that lead to injury and death of renal tubule cells. 7 Cisplatin has also been shown to incite local inflammation, further contributing to tubule damage.…”

“…11 Both mannitol and furosemide have been used to protect patients against cisplatininduced nephrotoxicity. 10,[12][13][14][15][16][17][18] However, the use of diuretics as renal prophylaxis with cisplatin infusion is the subject of a debate that has been ongoing for at least the past decade. Although a number of recent studies have examined the impact of diuretic choice on nephrotoxicity observed with higher doses of cisplatin, there are only very limited data, if any, examining the utility of these strategies when low doses of cisplatin are used or specifically in the context of its concurrent administration with whole pelvic radiotherapy.…”