[Can cisplatin renal toxicity be prevented?]

Cis diamminedichloroplatinum (CDDP) is a widely used anticancer agent particularly effective in the treatment of solid tumors. Dose limiting toxicity of CDDP was shown to be renal. Numerous methods to reduce this nephrotoxicity have been proposed. Hydration remains the best protection against acute CDDP nephrotoxicity in both the clinical and experimental setting. In man, no controlled studies have demonstrated the efficacy of furosemide and mannitol in the reduction of the CDDP renal toxicity. Studies have shown, however, that sodium thiosulfate offers some nephroprotection. To date, no controlled studies have demonstrated any benefit in the use of calcium channel blockers on CDDP renal toxicity in man. New drugs such as carboplatin have recently been introduced that theoretically have less renal toxicity, but evidence to support these claims are lacking. CDDP nephro protection remains a problem of current clinical interest and has yet not to be totally resolved.