Evaluation of the effect of acetazolamide versus mannitol on cisplatin-induced nephrotoxicity, a pilot study
- 513 Downloads
Background Cisplatin-induced nephrotoxicity still occurs despite the intensive hydration approach adapted to prevent its occurrence. Objective Evaluation of the effect of acetazolamide (ACTZ) on minimizing cisplatin-induced nephrotoxicity compared to mannitol when added to hydration regimen. Setting Nasser Institute Cancer Center (NICC), Cairo, Egypt. Method A total of 35 patients planned to receive cisplatin were divided into two groups: 20 patients received mannitol and 15 patients received ACTZ. Both groups received standard hydration measures as well for prevention of cisplatin-induced nephrotoxicity. Main outcome measure Patients’ kidney function was assessed using serum creatinine, creatinine clearance and blood urea nitrogen. Kidney injury was assessed using RIFLE criteria. Patients’ liver function tests and hematological parameters were also monitored. Results Patients in the mannitol group showed higher risk of developing kidney injury (30%) whereas those in the ACTZ group showed lower risk (8.9%), relative risk (RR) 0.269, 95% CI 0.108–0.815. No statistically significant difference occurred between the two groups concerning liver function tests or hematological parameters. Conclusion Use of ACTZ in addition to intensive hydration may have more beneficial effect on minimizing cisplatin-induced nephrotoxicity compared to mannitol plus intensive hydration approach. A large multicenter randomized clinical trials is recommended to confirm study results and to assess effect of ACTZ on tumor response.
KeywordsAcetazolamide Cisplatin Kidney function Mannitol Nephrotoxicity Platinum
Availability of data and materials
The datasets generated during and/or analyzed during the current study are available from the corresponding author on request.
Conflicts of interest
The authors declare that they have no conflict of interest.
- 8.Portilla D, Safar AM, Shannon ML, Penson RT. Cisplatin nephrotoxicity Uptodate (2015).Google Scholar
- 14.Faig J, Haughton M, Taylor RC, D’Agostino RB, Whelen MJ, Porosnicu Rodriguez KA, et al. Retrospective analysis of cisplatin nephrotoxicity in patients with head and neck cancer receiving outpatient treatment with concurrent high-dose cisplatin and radiotherapy. Am J Clin Oncol. 2016;41(5):432–40.CrossRefGoogle Scholar
- 22.Bauer L. In: McGraw H, editor. Applied clinical pharmacokinetics. New York: Edical Publishing Division; 2001. p. 93–179.Google Scholar
- 23.Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure—definition, outcome measures, animal models, fluid therapy and information technology needs: the second international consensus conference of the acute dialysis quality initiative (ADQI) group. Crit Care. 2004;8(4):R204–12.CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Aronoff G, Bennett W, Berns J, Brier M, Kasbekar N, Mueller B, et al. Drug prescribing in renal failure dosing guidelines for adults and children. 5th ed. Philadelphia: American College of Physicians; 2007.Google Scholar
- 30.Osman N, Copley M, Litterst C. Amelioration of cisplatin-induced nephrotoxicity by the diuretic acetazolamide in F344 rats. Cancer Treat Rep. 1983;68(7–8):999–1004.Google Scholar
- 34.Muraki K, Koyama R, Honma Y, Yagishita S, Shukuya T, Ohashi R, et al. Hydration with magnesium and mannitol without furosemide prevents the nephrotoxicity induced by cisplatin and pemetrexed in patients with advanced non-small cell lung cancer. J Thorac Dis. 2012;4(6):562–8.PubMedPubMedCentralGoogle Scholar
- 40.Launay-Vacher V, Rey JB, Isnard-Bagnis C, Deray G, Daouphars M. Prevention of cisplatin nephrotoxicity: state of the art and recommendations from the European society of clinical pharmacy special interest group on cancer care. Cancer Chemother Pharmacol. 2008;61(6):903–9.CrossRefPubMedGoogle Scholar