Nephrotoxicity and hydration management for cisplatin, carboplatin, and ormaplatin

Area of Science:

• Nephrology
• Oncology
• Pharmacology

Background:

• Renal toxicity is a significant adverse effect of platinum-based chemotherapy agents.
• Cisplatin, carboplatin, and ormaplatin are associated with varying degrees of kidney damage.
• Understanding the mechanisms and prevention strategies for chemotherapy-induced nephrotoxicity is crucial.

Purpose of the Study:

• To review the pathophysiology of renal toxicity for cisplatin, carboplatin, and ormaplatin.
• To summarize current knowledge on maneuvers to prevent or mitigate therapy-induced renal toxicity.
• To provide practical recommendations for protecting kidney function during platinum-based chemotherapy.

Main Methods:

• Literature review of studies on platinum-based chemotherapy and renal toxicity.
• Analysis of the mechanisms of nephrotoxicity for individual platinum agents.
• Evaluation of the efficacy of preventive strategies like hydration and pharmacologic interventions.

Main Results:

• Cisplatin nephrotoxicity can be managed with hydration; mannitol may be beneficial in specific cases, while furosemide is generally not recommended.
• Carboplatin requires hydration for patients with renal impairment or those receiving high doses (≥800 mg/m²).
• Or maplatin exhibits less prominent renal toxicity when administered with hydration similar to cisplatin protocols.

Conclusions:

• Nephroprotection strategies vary depending on the specific platinum agent used.
• Adequate hydration is a key component in preventing renal toxicity for cisplatin, carboplatin, and ormaplatin.
• Implementing tailored preventive measures can help preserve kidney function in patients undergoing platinum-based chemotherapy.