[Hyponatremia during treatment with cisplatin]

Area of Science:

• Oncology
• Nephrology

Background:

• Cisplatin is a cornerstone chemotherapy agent for various cancers.
• Cisplatin regimens are associated with a 4-10% incidence of hyponatremia, characterized by salt wasting, hypomagnesemia, and normokalemia.
• Potential complications include renal failure and orthostatic hypotension.

Observation:

• A patient with non-small-cell lung cancer and brain metastases developed hyponatremia with confusion after cisplatin administration.
• The condition was diagnosed as cisplatin-induced salt wasting.
• Treatment involved prolonged salt supplementation and substitution of cisplatin with carboplatin.

Findings:

• Cisplatin-induced hyponatremia is a recognized clinical entity requiring targeted management.
• Sodium repletion can be a lengthy process, sometimes taking months.
• Carboplatin serves as a viable alternative to cisplatin in cases of significant hyponatremia.

Implications:

• Effective management strategies are crucial for patients undergoing cisplatin-based chemotherapy.
• Understanding and addressing electrolyte imbalances like hyponatremia can improve patient outcomes.
• Carboplatin offers a safer alternative for patients susceptible to cisplatin-induced hyponatremia.