Cisplatin-induced renal toxicity: possible reversal by N-acetylcysteine treatment

Cisplatin administration is frequently associated with renal insufficiency and tubular dysfunction. In this article, a case of massive cisplatin overdose as a result of an accidental substitution for carboplatin is reported. The patient developed oliguric renal failure, hepatotoxicity, ototoxicity, peripheral neuropathy, blindness, and severe myelosuppression. A therapeutic trial with N-acetylcysteine to reverse renal toxicity was attempted. This article reviews the literature on cisplatin nephrotoxicity, with an emphasis on possible mechanisms involved, and suggests therapy for its modification.