الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cisplatin is one of the most commonly used drugs in the chemotherapy of solid tumors. The major adverse effect of cisplatin is nephrotoxicity, with an incidence of up to 25%. Cisplatin accumulates in the kidneys (in DNA of renal cells), and the nephrotoxic effect of cisplatin is proportional to the accumulated drug dose. The aim of this study was to assess the incidence of nephrotoxicity following cisplatin treatment and identify the most risk factors which preclude nephrotoxicity.
Nephrotoxicity was evaluated by the GFR and creatinine clearance (CrCl) using theCockcroft and Gault formula, and not only by serum creatinine (SCR).
85 out of 415 patients, who received cisplatin chemotherapy, had an increase in creatinine level > 1.5 times of baseline and decrease in creatinine clearance >/ 25% of baseline (nephrotoxicity). Patients were divided into two groups: group of patients who developed nephrotoxicity and another group of patients who did not develop nephrotoxicity. The two groups were compared in terms of cumulative dose of cisplatin, number of cycles, age, gender, diabetes mellitus, hypertension, smoking, anaemia, prescence of previous chemotherapy, prescence of combination chemotherapy.
The incidence of nephrotoxicity was higher with increased number of cycles (>8 cycles), increased cumulative dose (>450 mg/m2), age (60yearsold), diabetes mellitus, smoking, anemia (Hb < 10), previous chemotherapy and combination chemotherapy including ESHAP regimen, DCF regimen, MVAC regimen, cisplatin and gemzar regimen, and cisplatin and 5FU regimen.
Despite the many recent physiopathological advances in the understanding of
the mechanism of anticancer drug nephrotoxicity, especially that of cisplatin, prevention still relies on a drug dosage decrease, hydration measures, and active screening for renal abnormalities as part of the usual pre-therapeutic biological work-up in patients treated with anticancer drugs. In addition, there are no specific recommendations or convincing data about the renal protective effect of the
administration of cisplatin and the subsequent step of nephrotoxicity.