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[Cisplatin nephrotoxicity: effects on fractional excretion of sodium and enzymuria]
C Cirami1, A M Bianchi, P Galigani
1Istituto di Clinica Medica II, Università di Pisa.
Abstract:
The effects (in five therapeutic cycles) of Cisplatin on urinary enzyme excretion (specific markers of tubular damage), fractional excretion of sodium, fractional reabsorption of phosphate, serum Creatinine and creatinine Clearance were assessed in 17 female patients with ovarian carcinoma. An immediate reduction of sodium fractional excretion was observed: this appears a more sensible Cisplatin-nephrotoxicity marker than serum Creatinine and creatinine Clearance. No significant variations were noted in fractional reabsorption of phosphate or urinary Lysozyme and Beta-2-microglobulin but there was a significant increase of other urinary enzymes, confirming the potential nephrotoxicity of DDP treatment.
Insights
Cisplatin treatment for ovarian cancer can harm kidneys. Early monitoring of sodium excretion is a better indicator of this kidney damage than serum creatinine levels.
Area of Science:
- Nephrology
- Oncology
- Clinical Chemistry
Background:
- Cisplatin (DDP) is a cornerstone chemotherapy for ovarian carcinoma.
- Chemotherapy-induced nephrotoxicity is a significant concern, necessitating reliable monitoring markers.
- Urinary enzyme excretion and renal function tests are potential indicators of kidney damage.
Purpose of the Study:
- To evaluate the effects of Cisplatin on renal function and urinary enzyme excretion in ovarian cancer patients.
- To identify sensitive markers for early detection of Cisplatin-induced nephrotoxicity.
Main Methods:
- Assessed urinary enzyme excretion, fractional excretion of sodium, fractional reabsorption of phosphate, serum creatinine, and creatinine clearance.
- Monitored 17 female patients with ovarian carcinoma over five therapeutic cycles of Cisplatin.
- Analyzed changes in biochemical markers in response to Cisplatin treatment.
Main Results:
- Observed an immediate reduction in fractional excretion of sodium, suggesting it as a sensitive marker for Cisplatin nephrotoxicity.
- Found no significant changes in fractional reabsorption of phosphate, urinary Lysozyme, or Beta-2-microglobulin.
- Noted a significant increase in other urinary enzymes, indicating potential kidney damage from Cisplatin (DDP).
Conclusions:
- Fractional excretion of sodium is a more sensitive early marker of Cisplatin-induced nephrotoxicity than serum creatinine or creatinine clearance.
- Cisplatin treatment is associated with potential nephrotoxicity, evidenced by increased urinary enzyme excretion.
- Further research is warranted to validate these findings and optimize monitoring strategies for chemotherapy-related kidney damage.