Review Article
Pathophysiology of Cisplatin-Induced Acute Kidney Injury
Table 1
General measures for prevention and treatment of cisplatin-induced AKI.
| (1) Determine renal function (GFR) before each session of cisplatin treatment | | (2) Determine the risk of AKI (high risk; females, elderly patients, dehydration, patients with CKD and repeated doses of cisplatin) | | (3) Adjust cisplatin dose according to patient's renal function | | (4) Start hydration (with saline) before cisplatin and maintain for at least 3 days after treatment | | (5) Watch for electrolyte wasting (e.g., Mg), replace appropriately | | (6) Avoid concomitant nephrotoxic agents (NSAIDs, aminoglycosides, contrast agents, etc.) | | (7) Determine renal function within 1 week of treatment | | (8) Amifostine may be considered in patients with high risk of AKI | | (9) Consider newer, less nephrotoxic platinums such as carboplatin and oxaliplatin | |
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GFR: glomerular filtration rate, AKI: acute kidney injury, CKD: chronic kidney injury, Mg: magnesium, and NSAIDs: nonsteroid anti-inflammatory drugs.
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