The Role of Mannitol as a Nephroprotectant in Patients Receiving Cisplatin Therapy

Morgan, Katherine P.; Savage, Scott W.

doi:10.1345/aph.1q333

Cited by 51 publications

(44 citation statements)

References 12 publications

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“…Nephrotoxicity of cisplatin is a restrictive factor for its clinical use in treating solid tumors (Yamada et al, 2011;Morgan et al, 2012). Unbound cisplatin is eliminated by kidney through glomerular filtration and tubular secretion, then accumulates in renal parenchymal cells (Miller et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Incidence of Cisplatin-Induced Nephrotoxicity and Associated Factors among Cancer Patients in Indonesia

Prasaja¹,

Sutandyo²,

Andrajati³

2015

Asian Pacific Journal of Cancer Prevention

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Background: Cisplatin is still used as a first-line medication for solid tumors. Nephrotoxicity is a serious side effect that can decrease renal function and restrict applicable doses. This research aimed to obtain the profile of cisplatin-induced nephrotoxicity and its associated factors in adult cancer patients at Dharmais National Cancer Hospital (DNCH). Materials and Methods: The design was cross-sectional with data obtained from patient medical records. We retrospectively reviewed adult cancer patients treated with cisplatin ≥60mg/m 2 for at least four consecutive chemotherapy cycles from August 2011 to November 2013. The nephrotoxicity criterion was renal function decline characterized by creatinine clearance <60 ml/min using the Cockroft-Gault (CG) equation. Results: Eighty-eight subjects received at least four chemotherapy cycles of cisplatin. The prevalence of cisplatin nephrotoxicity was 34.1%. Symptoms could be observed after the first cycle of chemotherapy, and the degree of renal impairment was higher with increased numbers of cycles (r=-0.946, r 2 =89.5%). Factors that affected the decline of renal function were patient age (p=0.008, OR=3.433, 95%CI= 1.363-8.645) and hypertension (p=0.026, OR=2.931, 95%CI=1.120-7.670). Conclusions: Cisplatin nephrotoxicity occurred in more than one-third of patients after the fourth cycle of chemotherapy and worsened after each cycle despite preventive strategies such as hydration. The decline of renal function induced by cisplatin ≥60 mg/m 2 was affected by age and hypertension.

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Section: Discussionmentioning

confidence: 99%

Incidence of Cisplatin-Induced Nephrotoxicity and Associated Factors among Cancer Patients in Indonesia

Prasaja¹,

Sutandyo²,

Andrajati³

2015

Asian Pacific Journal of Cancer Prevention

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“…Forced diuresis with intravenous normal saline or hypertonic saline is used to counteract the toxic effect of chloride on the cis-position of the molecule. The addition of mannitol to induce a forced diuresis is sometimes used, but evidence of benefit is lacking; in some cases, this approach may cause worsened kidney function (33). Amifostine is a glutathione analog taken up by normal cells that blunts cisplatin-induced cellular injury.…”

Section: Tubules: Acute Tubular Injury Cisplatinmentioning

confidence: 99%

Onco-Nephrology

Perazella

2012

Clinical Journal of the American Society of Nephrology

275

197

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SummaryDespite dramatic improvements in patient survival and drug tolerability, nephrotoxicity remains an important complication of chemotherapy. Adverse renal effects occur because of innate drug toxicity and a number of patient-and drug-related factors. To provide cutting edge care for these patients, nephrologists and oncologists must be familiar with the nephrotoxicity of these drugs, particularly their associated clinical and laboratory manifestations. Rapid diagnosis, targeted treatment, and supportive care are critical to improving care for these patients. Unfortunately, some patients who develop nephrotoxicity will be left with long-term complications such as chronic tubulopathies and CKD. Onco-Nephrology is a new area that is rapidly expanding and requires a close working relationship between oncologists and nephrologists.

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“…To prevent ciplatin-induced nephrotoxicity, mannitol was used as an osmotic diuretic (15), and magnesium sulfate as a nephroprotective, agent (16). Bodnar showed the efficacy of magnesium salt supplementation against ciplatin-induced nephrotoxicity in a double-blind placebo-controlled randomized study (16).…”

Section: Discussionmentioning

confidence: 99%

The safety and effect of chemotherapy with short hydration for urothelial cancer on patients’ quality of life

Azuma

Matayoshi

Sato

et al. 2016

Japanese Journal of Clinical Oncology

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Objective: Our aim was 2-fold: first, to assess the safety of short hydration treatment for urothelial cancer; and second, to assess the resultant quality of life of patients who received the treatment. Methods: We assessed 61 patients including 31 outpatients and 30 inpatients, who received a combination of gemcitabine and cisplatin chemotherapy with short hydration. The serum creatinine (Cr) level and the estimated glomerular filtration rate were measured to assess renal function using linear mixed model analysis. To assess quality of life, the patients were asked to respond to the Functional Assessment of Cancer Therapy-General questionnaire. The responses were then analyzed using the paired t-test. Results: Patients who received short hydration chemotherapy showed no significant change in serum Cr level (P = 0.423) or estimated glomerular filtration rate (P = 0.582). There was also no significant change in serum Cr level or estimated glomerular filtration rate between patients who received short hydration chemotherapy and those who received consecutive hydration chemotherapy (P = 0.154 and 0.311, respectively). In every patient, the Functional Assessment of Cancer Therapy-General total score and subscale scores both improved as a result of outpatient chemotherapy with short hydration (P < 0.01). Conclusions: The short hydration gemcitabine and cisplatin regimen for patients with urothelial cancer was safe. Further, the outpatient chemotherapy was found not only to be safe, but also to have improved the patients' quality of life.

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The Role of Mannitol as a Nephroprotectant in Patients Receiving Cisplatin Therapy

Cited by 51 publications

References 12 publications

Incidence of Cisplatin-Induced Nephrotoxicity and Associated Factors among Cancer Patients in Indonesia

Incidence of Cisplatin-Induced Nephrotoxicity and Associated Factors among Cancer Patients in Indonesia

Onco-Nephrology

The safety and effect of chemotherapy with short hydration for urothelial cancer on patients’ quality of life

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