Histopathological study of human cisplatin nephropathy

The present study was conducted to obtain detailed information on the morphological changes in the human kidney as related to cisplatin therapy. The kidneys of ten autopsy cases showing impaired renal function following cisplatin therapy with hydration were examined histologically. Sporadic lesions of degeneration, necrosis, and regenerative changes were observed in the pars convoluta and pars recta of the proximal tubule, distal tubule, and collecting duct. Enlarged and pleomorphic nuclei in regenerated epithelial cells and hyperplasia of the collecting duct lining cells were considered to be specific histological findings in renal injury related to cisplatin therapy. Electron microscopic examination of a case receiving a large dose of cisplatin without signs of renal insufficiency showed an increased number of cytosomes containing electron dense granules in all tubular portions and conspicuous nuclear indentation in the thin limb of the loop of Henle and collecting duct. The platinum concentration in autopsy organs and biopsy cases was analyzed, but no correlation could be found between the concentration level of platinum in the kidney and impairment of renal function.