Does cisplatin cause nephrotoxicity?
Cisplatin is a widely used and highly effective cancer chemotherapeutic agent. One of the limiting side effects of cisplatin use is nephrotoxicity. Research over the past 10 years has uncovered many of the cellular mechanisms which underlie cisplatin-induced renal cell death.
How is cisplatin nephrotoxicity treated?
Active hydration with saline and simultaneous administration of mannitol before, during and after cisplatin treatment, significantly reduce cisplatin nephrotoxicity and this strategy has been accepted as the standard of care for reducing the associated side effects53).
Is cisplatin-induced nephrotoxicity reversible?
Cisplatin injures multiple renal compartments, including blood vessels, glomeruli, and most commonly, the tubules (29). Nephrotoxicity is generally reversible, but it can be permanent. Tubular injury as manifested by AKI and tubular dysfunction syndromes will be described.
What is chemotherapy induced nephrotoxicity?
Anticancer drug nephrotoxicity is an important and increasing adverse drug event that limits the efficacy of cancer treatment. The kidney is an important elimination pathway for many antineoplastic drugs and their metabolites, which occurs by glomerular filtration and tubular secretion.
What is cisplatin-induced kidney injury?
Cisplatin has been suggested to cause damage to the vasculature within renal tubules [12]. It results in vascular resistance and constriction of vascular smooth muscle cells (VSMC) leading to reduced renal blood flow, decreased GFR, and hypoxia of renal tubular cells, leading to kidney damage [31,108].
How do you reduce nephrotoxicity?
General Measures to Prevent Drug-Induced Nephrotoxicity Avoid nephrotoxic combinations. Correct risk factors for nephrotoxicity before initiation of drug therapy. Ensure adequate hydration before and during therapy with potential nephrotoxins. Use equally effective non-nephrotoxic drugs whenever possible.
How is nephrotoxicity treated?
Nephrotoxicity from IL-2 is generally reversible and managed by administering fluid boluses at the onset of oliguria [95,96]. Additionally, vasopressors such as low and intermediate-dose dopamine are used in treatment of oliguria and hypotension by cross-talk with adrenergic receptors [97,98].
How do you treat nephrotoxicity?
How do you Treat Nephrotoxicity?
- The renal failure can be managed by maintaining the fluid volume in body, start dialysis or adjust drug doses.
- The drug causing nephrotoxicity must be discontinued or its dose be altered.
- In some conditions, steroid therapy may help.
- Maintaining electrolyte balance.
How do you prevent nephrotoxicity?
Useful strategies to avoid nephrotoxicity from these drugs include using analgesics with less prostaglandin activity (acetaminophen, aspirin, sulindac, and nabumetone), correcting volume depletion before starting the drug, and monitoring renal function and vital signs when starting or increasing the dose of the drug.
Why does cisplatin need hydration?
Hydration is recommended to induce diuresis and reduce the concentration of cisplatin in the kidneys.