Magnesium supplementation and high volume hydration reduce the renal toxicity caused by cisplatin-based chemotherapy in patients with lung cancer: a toxicity study
Oka T, Kimura T, Suzumura T, Yoshimoto N, Nakai T, Yamamoto N, Matsuura K, Mitsuoka S, Yoshimura N, Kudoh S, Hirata K
BMC pharmacology & toxicology · 31 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (classified by our AI screen)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2014-12-01 · BMC Pharmacol Toxicol · vol. 15 · issue 1 · p. 70
- Publisher
- BioMed Central
- Cited
- 47 citations · more than 89% of similar papers · 2.6× the field average
- References
- 25 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Chemotherapy-induced organ toxicity mitigation · Magnesium in Health and Disease · Potassium and Related Disorders
- Keywords
- Toxicity, Cisplatin, Renal function, Creatinine, Urology, Medicine, Chemotherapy, Diuresis, Pharmacology, Internal medicine
- MeSH
- humans, lung neoplasms, kidney diseases, cisplatin, magnesium, water, creatinine, serum albumin, hemoglobins, antineoplastic agents, antineoplastic combined chemotherapy protocols, rehydration solutions, aged, middle aged, female, male
11 authors
From JP
- Takako OkaOsaka City University
- Tatsuo Kimura · correspondingOsaka City University; Osaka City University Hospital
- Tomohiro SuzumuraIzumi City General Hospital
- Naoki YoshimotoOsaka City University
- Toshiyuki NakaiOsaka City University
- Norio YamamotoOsaka City University
Abstract
Background
Renal toxicity is a clinical problem that affects 28-42% of patients undergoing treatment with cisplatin. Renal toxicity can be minimized by high volume hydration with mannitol diuresis. Recent reports have shown that cisplatin induces depletion of Mg and that Mg supplementation can reduce renal toxicity. We hypothesized that Mg infusion combined with low volume hydration may not be sufficient to overcome cisplatin-induced renal toxicity.
Methods
In total, 85 patients with lung cancer receiving their first cycle of cisplatin-based chemotherapy at the Osaka City University Hospital were classified into three groups: those administered high volume hydration without Mg infusion (high-volume Mg-), high volume hydration with Mg infusion (high-volume Mg+), and with low volume hydration with Mg infusion (low-volume Mg+). Serum creatinine (sCr) and creatinine clearance (CrCl) were examined before and after treatment with cisplatin. Multivariable analysis was carried out to identify the most important contributing factors.
Results
There were no significant differences in pre-treatment sCr levels or CrCl between groups. In the high-volume Mg- group, post-treatment sCr significantly increased compared with pre-treatment levels, while post-CrCl significantly decreased compared with pre-treatment CrCl (p < 0.001 and p < 0.001, respectively). In the high-volume Mg+ group, there was no significant difference between pre- and post-treatment levels of sCr, or between pre- and post-treatment CrCl (p = 0.118 and p = 0.254, respectively). In the low-volume Mg+ group, there was a trend towards increased sCr levels and decreased CrCl after treatment (p = 0.068 and p = 0.055, respectively). Multivariate analysis revealed that the absence of Mg infusion and low-volume hydration were both independent factors for decreased CrCl (p < 0.001 and p = 0.001, respectively).
Conclusions
High-volume hydration and Mg infusion reduces the renal toxicity induced by cisplatin. A low-volume Mg+ regimen may be considered for patients with adequate renal function.
Trial registration
Observational Study UMIN000013950; Registered 13 May 2014.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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