What Is Cisplatin Nephrotoxicity?

Cisplatin nephrotoxicity refers to kidney damage, which is a major side effect of this cancer drug, especially at high doses. Scientists are unsure why cisplatin accumulates in the kidneys at higher levels than in other organs. Preventive measures like extra hydration and forced urination can help decrease cisplatin nephrotoxicity side effects. Sulfa drugs given with cisplatin might also block toxic effects of the drug on the kidneys.

Kidney damage might affect up to one-third of all patients given cisplatin to stop tumor growth. The risk of cisplatin nephrotoxicity increases with higher doses of this platinum compound chemical. During chemotherapy treatment, the metal is absorbed by human tissue before it is excreted in the urine, usually within a few days, from the liver, lungs, testes, and other organs. The drug reacts differently on the kidneys, with higher levels of the drug remaining after infusion. This reaction might be particularly important when treating elderly patients and patients with kidney disorders.

Researchers discovered that increasing the amount of fluids before, during, and after intravenous infusion of the chemical might reverse cisplatin nephrotoxicity. Cisplatin is only administered intravenously, with no oral form of the drug in use. Cancer specialists typically add a saline solution while infusing the medication and recommend patients drink up to 3 quarts (about 2.8 liters) of fluid a day to flush metals from the kidneys.

Diuretics might also be used to force urination and clear the drug from kidneys, along with sulfa drugs. Sulfa drugs given to patients with ovarian cancer, for example, might effectively allow high doses of chemotherapy without causing kidney damage. Other detoxification agents might also help.

Researchers discovered the powerful anti-tumor properties of platinum-based drugs in the early 1970s, especially when treating tumors in the lungs, bladder, breast, uterus, head, and neck. High doses of the drug needed to kill cancer cells also caused cisplatin nephrotoxicity, scientists found. They believe the drug alters DNA in certain cells found in kidneys.

In addition to this side effect, magnesium levels might fall dangerously low after chemotherapy treatment with the drug. Magnesium is critical for proper functioning of the central nervous system, heart, and muscles. Supplements might reverse these deficiencies.

Most common side effects resolve within a couple of weeks after treatments cease. They include vomiting and nausea, which might be controlled with anti-nausea medication. Anemia or low white blood cell counts might also occur, which represent a common side effect of many chemotherapy drugs. These chemicals typically kill healthy cells along with malignant cells, which might hinder the body’s immune system in fighting infection.