Renal and electrolyte disturbances associated with cisplatin

Cisplatin is a coordinate metal complex with significant antineoplastic activity and various effects, including acute anc chronic renal insufficiency and renal magnesium wasting. Nephrotoxicity may occur in as many as 50% to 75% of patients receiving the drug, and is apparently due to renal tubular injury. Although controlled, prospective clinical trials are lacking, the available data indicate that the frequency and severity of cisplatin nephrotoxicity may be reduced by slow infusion rates; hydration before, during, and immediately after administration of cisplatin; and concomitant administration of mannitol. Preliminary animal studies indicate that chloride-containing vehicles such as 0.9% sodium chloride may prevent the aquation or hydroxylation of cisplatin and reduce its toxicity. No information is available on th prevention of cisplatin associated renal magnesium wasting. However, frequent measurement of serum cations and appropriate replacement are recommended.