Nephrotoxicity Evaluation in Outpatients Treated with Cisplatin-Based Chemotherapy Using a Short Hydration Method


Background: To evaluate cisplatin-induced nephrotoxicity in outpatients receiving chemotherapy with cisplatin alone or in combination with other agents using a short hydration method. Methods: Forty-nine patients enrolled in the study were monitored during 3 cycles of chemotherapy. Cisplatin was given in 1000 mL of 0.9% NaCl solution for 90 min as an intravenous infusion. Renal parameters were evaluated before and after each chemotherapy cycle, and 6 weeks after the completion of treatment. Results: Blood urea nitrogen, creatinine, and cystatin C levels increased significantly during the 3 cycles of chemotherapy, whereas sodium and potassium levels decreased significantly. Magnesium and calcium levels decreased only during the second cycle of chemotherapy. Significant increases in uric acid level were observed during the 1st and 3rd cycles, and 6 weeks after the completion of treatment. Conclusions: The method used in our study shows minimal changes in renal functions. To effectively monitor nephrotoxicity, renal parameters and electrolyte levels should be measured before and after each cisplatin based chemotherapy cycle. More investigations are required to evaluate this method with higher doses of cisplatin.

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S. Tezcan, F. Izzettin, M. Sancar, P. Yumuk and S. Turhal, "Nephrotoxicity Evaluation in Outpatients Treated with Cisplatin-Based Chemotherapy Using a Short Hydration Method," Pharmacology & Pharmacy, Vol. 4 No. 3, 2013, pp. 296-302. doi: 10.4236/pp.2013.43043.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] D. H. Honda, “Role of the Clinical Pharmacist in Oncology Care,” Frontiers of Radiation Therapy and Oncology, Vol. 15, 1980, pp. 157-161.
[2] D. M. Stull, A. Iannucci and R. Bertin, “Board-Certified Oncology Pharmacists: Partners in the Multidisciplinary Care of Cancer Patients,” Community Oncology, Vol. 3, No. 5, 2006, pp. 284-286. doi:10.1016/S1548-5315(11)70696-9
[3] E. R. Bremberg, C. Hising, U. Nylén, H. Ehrsson and S. Eksborg, “An Evaluation of Pharmacist Contribution to an Oncology Ward in a Swedish Hospital,” Journal of Oncology Pharmacy Practice, Vol. 12, No. 2, 2006, pp. 75-81. doi:10.1177/1078155206070412
[4] C. D. Duong and J. Y. Loh, “Laboratory Monitoring in Oncology,” Journal of Oncology Pharmacy Practice, Vol. 12, No. 4, 2006, pp. 223-236. doi:10.1177/1078155206072982
[5] J. M. Medina and C. Fausel, “Cancer Treatment and Chemotherapy,” In: J. Dipiro, R. Tolberto, G. Yee, G. Matzke, B. Wells and L. Posey, Eds., Pharmacotherapy a Pathophsiologic Approach, McGrow-Hill Medical Publishing Division, New York, 2005, p. 2100.
[6] P. E. Kintzel, “Anticancer Drug-Induced Kidney Disorders: Incidence, Prevention and Management,” Drug safety, Vol. 24, No. 1, 2001, pp. 19-38. doi:10.2165/00002018-200124010-00003
[7] G. Giaccone, M. Donadio, P. Ferrati, L. Ciuffreda, M. Bagatella, M. Gaddi and A. Calciati, “Disorders of Serum Electrolytes and Renal Function in Patients Treated with Cis-Platinum on an Outpatient Basis,” European Journal of Cancer & Clinical Oncology, Vol. 2, No. 4, 1985, pp. 433437. doi:10.1016/0277-5379(85)90033-1
[8] O. Kayaalp, “Antibiyotikler ve Diger Kemoterapötikler,” In: O. Kayaalp, Ed., Tibbi Farmakoloji, Hacettepe Tas, Ankara, 2005, pp. 333-334.
[9] G. K. McEvoy, E. K. Snow and L. Kester, In: G. K. McEvoy, E. K. Snow and L. Kester, “AHFS Drug Information,” American Society of Health-System Pharmacist, 2006, pp. 979-984.
[10] O. Kayaalp “Türkiye Ilaç Kilavuzu TIK-6 2011-12 Formüleri,” Pelikan Yayincilik, Ankara, 2005, p. 598.
[11] X. Yao, K. Panichpisal, N. Kurtzman and K. Nugent, “Cisplatin Nephrotoxicity: A Review,” The American Journal of the Medical Sciences, Vol. 334, No. 2, 2007, pp. 115-124. doi:10.1097/MAJ.0b013e31812dfe1e
[12] J. Gaedeke, L. M. Fels, C. Bokemeyer, U. Mengs, H Stolte and H. Lentzen, “Cisplatin Nephrotoxicity and Protection by Silibinin,” Nephrology Dialysis Transplantation, Vol. 11, No. 1, 1996, pp. 55-62. doi:10.1093/oxfordjournals.ndt.a027066
[13] M. S. Razzaque, “Cisplatin Nephropathy: Is Cytotoxicity Avoidable?” Nephrology Dialysis Transplantation, Vol. 22, No. 8, 2007, pp. 2112-2116. doi:10.1093/ndt/gfm378
[14] D. M. Townsend, M. Deng, L. Zhang, M. G. Lapus and M. H. Hanigan, “Metabolism of Cisplatin to a Nephrotoxin in Proximal Tubule Cells,” Journal of the American Society of Nephrology, Vol. 14, No. 1, 2003, pp. 1-10. doi:10.1097/01.ASN.0000042803.28024.92
[15] N. V. Lyubimova, S. V. Topchieva, S. G. Averinova, A. V. Kashkadaeva, V. A. Gorbunova, S. V. Shiryaev and N. E. Kushlinskii, “Modern Methods for Diagnosis and Monitoring of Nephrotoxicity during Antitumor Therapy with Platinum Derivatives,” Bulletin of Experimental Biology and Medicine, Vol. 130, No. 3, 2000, pp. 886-891. doi:10.1007/BF02682261
[16] C. M. Keaney and J. E. Springate, “Cancer and the Kidney,” Adolescent Medicine Clinics, Vol. 16, No. 1, 2005, pp. 121-148. doi:10.1016/j.admecli.2004.09.012
[17] B. Tokgoz, “Renal Abnormalities during Malignancies and Chemotherapy Related ARF,” Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, Vol. 15, No. 1, 2006, pp. 7986.
[18] T. L. Cornelison and E. Reed, “Nephrotoxicity and Hydration Management for Cisplatin, Carboplatin, and Ormaplatin,” Gynecologic Oncology, Vol. 50, No. 2, 1993, pp. 147-158. doi:10.1006/gyno.1993.1184
[19] J. T. Santoso, J. A. Lucci 3rd, R. L. Coleman, I. Schafer and E. V. Hannigan, “Saline, Mannitol, and Furosemide Hydration in Acute Cisplatin Nephrotoxicity: A Randomized Trial,” Cancer Chemotherapy and Pharmacology, Vol. 52, No. 1, 2003, pp. 13-18. doi:10.1007/s00280-003-0620-1
[20] M. Tiseo, O. Martelli, A. Mancuso, M. P. Sormani, P. Bruzzi, R. Di Salvia, F. De Marinis and A. Ardizzoni, “Short Hydration Regimen and Nephrotoxicity of Intermediate to High-Dose Cisplatin-Based Chemotherapy for Outpatient Treatment in Lung Cancer and Mesothelioma,” Tumori, Vol. 93, No. 2, 2007, pp. 138-144.
[21] B. Kömürcüoglu, M. Büyüksirin, H. Isgüder, D. Kalenci and E. Özden, “Is it Necessary to Evaluate the Magnesium and Calcium Levels in Cisplatinum Treated Lung Cancer Patients?” Izmir Gögüs Hastanesi Dergisi, Vol. 18, No. 3, 2004, pp. 101-106.
[22] P. Benöhr, A. Grenz, J. T. Hartmann, G. A. Müller and S. Blaschke, “Cystatin C—A Marker for Assessment of the Glomerular Filtration Rate in Patients with Cisplatin Chemotherapy,” Kidney and Blood Pressure Research, Vol. 29, No. 1, 2006, pp. 32-35. doi:10.1159/000092485
[23] E. Kurt, T. Evrensel, G. Gönüllü, Ö. Kanat, M. Demiray, M. Arslan, Ö. ünlü, K. Dilek and O. Manavoglu, “Cisplatin-Induced Renal Toxicity and Evaluation of the Efficacy of Synthetic Oral Prostaglandin E1 Analogue,” Uludag üniversitesi Tip Fakültesi Dergisi, Vol. 28, No. 2, 2002, pp. 17-20.
[24] R. T. Skeel, “Antineoplastic Drugs and Biologic Response Modifiers: Classification, Use, and Toxicity of Clinically Useful Agents,” In: R. T. Skeel, Ed., Handbook of Cancer Chemotherapy, Lippincott Williams & Wilkins, Philadelphia, 2007, pp. 693-843.
[25] V. Launay-Vacher, J. B. Rey, C. Isnard-Bagnis, G. Deray and M. Daouphars, “Prevention of Cisplatin Nephrotoxicity: State of the Art and Recommendations from the European Society of Clinical Pharmacy Special Interest Group on Cancer Care,” Cancer Chemother Pharmacol, Vol. 6, No. 6, 2008, pp. 903-918. doi:10.1007/s00280-008-0711-0
[26] J. Nicholas, N. J. Vogelzang, J. L. Torkelson and B. J. Kennedy, “Hypomagnesemia, Renal Dysfunction, and Raynaud’s Phenomenon in Patients Treated with Cisplatin, Vinblastine, and Bleomycin,” Cancer, Vol. 56, No. 12, 1985, pp. 2765-2770. doi:10.1002/1097-0142(19851215)56:12<2765::AID-CNCR2820561208>3.0.CO;2-2
[27] M. Martin, E. Diaz-Rubio, A. Casado, J. M. Lopez Vega, J. Sastre and J. Almenarez, “Intravenous and Oral Magnesium Supplementations in the Prophylaxis of CisplatinInduced Hypomagnesemia. Results of a Controlled Trial,” American Journal of Clinical Oncology, Vol. 15, No. 4, 1992, pp. 348-351. doi:10.1097/00000421-199208000-00016
[28] B. Stabuc, L. Vrhovec, M. Stabuc-Silih and T. E. Cizej, “Improved Prediction of Decreased Creatinine Clearance by Serum Cystatin C: Use in Cancer Patients before and during Chemotherapy,” Clinical Chemistry, Vol. 46, No. 2, 2000, pp. 193-197.
[29] R. Hojs, S. Bevc, R. Ekart, M. Gorenjak and L. Puklavec, “Serum Cystatin C as an Endogenous Marker of Renal Function in Patients with Mild to Moderate Impairment of Kidney Function,” Nephrology Dialysis Transplantation, Vol. 21, No. 7, 2006, pp. 1855-1862. doi:10.1093/ndt/gfl073
[30] F. J. Hoek, F. A. Kemperman and R. T. Krediet, “A Comparison between Cystatin C, Plasma Creatinine and the Cockcroft and Gault Formula for the Estimation of Glomerular Filtration Rate,” Nephrology Dialysis Transplantation, Vol. 18, No. 10, 2003, pp. 2024-2031. doi:10.1093/ndt/gfg349

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