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Cisplatin nephrotoxicity: a multivariate analysis of potential predisposing factors
J L Lagrange1, B Médecin, M C Etienne
1Centre Antoine Lacassagne, Nice, France.
Pharmacotherapy
|December 17, 1997
Summary
Ultrafilterable platinum levels predict cisplatin-induced kidney damage. Early identification of patients at risk for renal dysfunction can be achieved by monitoring platinum concentrations, aiding in clinical strategy development.
Area of Science:
- Nephrology
- Oncology
- Pharmacology
Background:
- Cisplatin is a widely used chemotherapy agent.
- Cisplatin can cause significant kidney damage (nephrotoxicity).
- Early identification of patients at risk for cisplatin-induced renal dysfunction is crucial for patient management.
Purpose of the Study:
- To evaluate biologic and pharmacologic parameters for early identification of cisplatin-induced renal dysfunction.
- To determine if platinum concentrations correlate with the intensity of renal dysfunction.
Main Methods:
- Prospective evaluation of 62 cancer patients receiving cisplatin.
- Renal function assessed by estimated creatinine clearance (Clcr) before and after each cycle.
- Total and ultrafilterable (UF) platinum levels measured 16 hours post-infusion.
Main Results:
- Renal dysfunction intensity (weighted relative decrease of Clcr) was independent of cisplatin dosage, age, sex, or cycle number.
- Higher total and UF platinum concentrations significantly correlated with greater renal dysfunction.
- UF platinum concentration was the sole significant factor in stepwise regression analysis for predicting renal dysfunction.
Conclusions:
- Ultrafilterable platinum concentration is a key predictor of cisplatin-induced renal dysfunction.
- These findings represent a first step towards a clinical strategy for identifying at-risk patients.
- Monitoring platinum levels may allow for proactive management to mitigate kidney damage.