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Related Experiment Videos

Cisplatin nephrotoxicity. Correlation with plasma platinum concentrations.

D P Kelsen, N Alcock, C W Young

    American Journal of Clinical Oncology
    |February 1, 1985
    PubMed
    Summary

    High peak plasma platinum concentrations, particularly above 6 micrograms/ml at 5 minutes after cisplatin (DDP) infusion, are linked to increased acute nephrotoxicity in cancer patients. Lower concentrations showed no significant toxicity.

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    Area of Science:

    • Nephrology
    • Oncology
    • Pharmacokinetics

    Background:

    • Cisplatin (DDP) is a widely used platinum-based chemotherapy agent.
    • Nephrotoxicity is a significant dose-limiting side effect of cisplatin therapy.
    • Understanding the relationship between platinum levels and toxicity is crucial for optimizing treatment.

    Purpose of the Study:

    • To investigate the correlation between early plasma platinum concentrations and the development of acute nephrotoxicity following cisplatin administration.
    • To identify potential thresholds for plasma platinum levels associated with increased risk of kidney damage.

    Main Methods:

    • Plasma platinum concentrations were measured at 5 minutes, 24 hours, and 48 hours post-cisplatin infusion in two patient groups receiving different DDP doses (100-120 mg/m2 and 35-60 mg/m2).

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  • Nephrotoxicity was defined as a >50% increase in serum creatinine from baseline at 24 or 48 hours.
  • Statistical analysis was performed to compare toxicity rates based on plasma platinum levels.

    • Main Results:

    • In patients receiving high-dose cisplatin (100-120 mg/m2), 5/20 with 5-minute plasma platinum levels >6 micrograms/ml developed nephrotoxicity, versus 0/26 with levels <6 micrograms/ml (p<0.05).
    • Plasma platinum concentrations at 24 and 48 hours were similar between toxic and non-toxic groups.
    • High peak platinum levels (>6 micrograms/ml at 5 minutes) were not observed in patients receiving lower-dose cisplatin (35-60 mg/m2), with only one case of nephrotoxicity.

    Conclusions:

    • Acute nephrotoxicity following cisplatin therapy appears to be associated with high peak plasma platinum concentrations.
    • Early plasma platinum monitoring, specifically at 5 minutes post-infusion, may help predict the risk of cisplatin-induced nephrotoxicity.
    • These findings support the importance of managing cisplatin dosing and monitoring to mitigate kidney damage.