The effect of cisplatin on renal function in patients with testicular tumours

A retrospective study was carried out on the immediate and delayed effects of cisplatin on renal function. 51Cr EDTA clearance was serially measured in 22 patients with testicular tumours treated with cisplatin based chemotherapy to a cumulative dose of 180 to 900 mg. The immediate effect of one to five courses of cisplatin was a 23% reduction in glomerular filtration rate (GFR) from a mean of 137 +/- 29.5 ml/min to 106 +/- 33 ml/min (P less than 0.01). Of 17 patients who were followed up from 6 to 60 months, five showed some recovery of function. Two of these five had complete recovery and three improved from a mean of 63% of initial clearance to 76% after 18 to 48 months. Seven patients showed no further change in function, the clearance remaining at a mean of 105 ml/min after 6 to 55 months and five demonstrated a further decrease in glomerular filtration rate, by a mean of 24 ml/min, after 6 to 60 months. We have concluded that there is an inevitable reduction in glomerular filtration rate with cisplatin chemotherapy. Full recovery of function is unusual and in some cases there is further deterioration without exposure to additional nephrotoxic agents.