A retrospective evaluation of furosemide and mannitol for prevention of cisplatin-induced nephrotoxicity
| Autor: | D. Nguyen, J. Shumway, C. Kha, Michelle Ludwig, K. M. Meaders, Claire M. Mach, M. Y. Williams-Brown, Matthew L. Anderson |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Renal Tubular Transport Inborn Errors Side effect medicine.medical_treatment Urology Uterine Cervical Neoplasms Renal function Antineoplastic Agents 030226 pharmacology & pharmacy Nephrotoxicity Hypomagnesemia 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Furosemide Risk Factors medicine Humans Mannitol Pharmacology (medical) Diuretics Proportional Hazards Models Retrospective Studies Pharmacology Cisplatin Creatinine business.industry Chemoradiotherapy Middle Aged medicine.disease chemistry 030220 oncology & carcinogenesis Anesthesia Female Kidney Diseases Diuretic business medicine.drug |
| Zdroj: | Journal of Clinical Pharmacy and Therapeutics. 42:286-291 |
| ISSN: | 0269-4727 |
| DOI: | 10.1111/jcpt.12509 |
| Popis: | SummaryWhat is known and objective Nephrotoxicity is a recognized side effect of cisplatin chemotherapy. However, the optimal strategy for preventing cisplatin-induced nephrotoxicity, if any, remains unclear. The primary objective for this study was to determine whether mannitol or furosemide provides better nephroprotection when administered with hydration prior to weekly, low-dose cisplatin concurrently with whole pelvic radiotherapy. Methods Clinical data were abstracted from all women who underwent chemoradiation for FIGO IB2-IVA cervical cancer at a regional safety net health system between January 2009 and December 2014. Creatinine clearance was estimated using the IDMS-traceable MDRD Study Equation. Descriptive statistics were used to summarize patient demographics. Cox proportional hazard models were used to identify factors associated with hypomagnesemia and survival. Results and discussion A total of 133 women received 656 weekly doses of single-agent cisplatin (40 mg/m2) concomitant with whole pelvic radiation. Furosemide (20 mg) was administered intravenously prior to 341 cisplatin doses, whereas mannitol (24 g) was administered prior to 315 doses. Significant magnesium wasting was observed after the second weekly cisplatin infusion regardless of whether furosemide or mannitol was utilized. Repetitive low-dose cisplatin infusion had no impact on measured levels of serum creatinine or estimated glomerular filtration rate. Prior history of hypertension, diabetes mellitus, hepatitis C infection and acute gastrointestinal toxicity were each associated with early onset of hypomagnesemia. What is new and conclusions Repetitive administration of low-dose cisplatin concurrent with whole pelvic radiation is associated with magnesium wasting. However, choice of diuretic with pretreatment hydration had no significant impact on the severity of this adverse effect. |
| Databáze: | OpenAIRE |
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