[Glutamin concentrations in patients treated with cisplatin have a predicting value of renal failure development]

Glutamine is an amino acid (AA) whose mission is carrying nitrogen. Abnormalities in protein and AA metabolism has been observed in patients with acute renal failure. Several clinical trials had showed abnormalities in plasma AA and its elimination in uremic environment. Moreover, renal failure disturbs hepato-splachnic circulation of glutamin, tyrosine and proline. Cisplatin is a key drug in the chemotherapy pharmacology, and the nephrotoxicity due to tubular injury, is one of its most important side effects, which sometimes is irreversible and leads to substitutive renal treatment. The goal of this work is to find predictive factors of renal failure secondary to cisplatin. Fifty four patients treated with cisplatin were studied. The plasma AA concentration and another plasmatic and urine parameters were measured in three different days after each pulse of chemotherapy. Plasma AA modifications through the pulses and reabsortion percentages of everyone were analysed too. Significant differences were observed in 13 AA reabsortion percentages and 16 plasmatic concentration. Glutamin concentration through the pulses was higher in 13 patients, (24%) who presented renal failure (Plasmatic glutamin concentration higher than 1000 mM/L at the third day after cisplatin administration was highly predictive value about getting renal failure, with significant difference from patients with o normal renal function. Others parameters analysed did not rise significant predictive values, so as it was not found relation between hyperaminoaciduria and renal function. It is concluded that cisplatin leads to renal failure in a 24% of this patients. Glutamin, concentrations higher than 1000 mM/L at the third day after cisplatin administration have a high predictive value about getting renal failure; so, it is suggested this could be a early marker of cisplatin nephrotoxicity before the serum creatinine is elevated, in order to get an early and suitable treatment of it.