Nephrotoxicity of cis‐platinum (II) dichlorodiammine
Nephrotoxicity of cis‐platinum (II) dichlorodiammine
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顺铂 (II) 二氯二胺的肾毒性
DOI：
10.1002/cpt1978234461
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发表时间：
1978
影响因子：
6.7
通讯作者：
S. Howell
中科院分区：
文献类型：
--
作者：
J. Stark;S. Howell
对15例接受顺铂(II)二氯二胺(CPDD)治疗的患者的肾功能进行了前瞻性的详细检查，以阐明肾毒性的早期证据。患者接受49个疗程的CPDD治疗，剂量为20 mg/m2/d，共5天，同时给予1000毫升生理盐水预合成。通过连续测定血清肌酐和肾小球滤过率(以~(125)I-硫代巴比妥酸清除量测量)和测量肾小管功能参数，包括肾小管对磷的重吸收、尿糖比、总蛋白、总免疫球蛋白轻链排泄量、血清电解质、尿液pH和比重，监测肾功能。在一个疗程内，平均血肌酐没有显著变化，也没有累积的血肌酐增加。在19个可评估的疗程中，有9个肾小球滤过率出现短暂的小幅下降，并迅速恢复。经过3个疗程的治疗，肾小球滤过率没有累积下降。4名既往存在肾功能不全的患者未出现明显的额外肾毒性。所有患者均未发现肾小管功能障碍。这项研究是首次对接受CPDD治疗的患者的多个肾功能参数进行前瞻性的详细检查，并揭示了唯一能显示这种给药程序的变化的参数是肾小球滤过率。
The renal function of 15 patients receiving cis‐platinum (II) dichlorodiammine (CPDD) was examined prospectively in detail to elucidate early evidence of nephrotoxicity. Patients were given a total of 49 courses of CPDD at 20 mg/m2/day for 5 days with 1,000 ml of saline prehydration. Renal function was monitored by serial determinations of serum creatinine and glomerular filtration rate (measured as 125I‐iothalamate clearance) and by measurement of parameters of tubular function, including tubular reabsorption of phosphorus, urine‐to‐serum glucose ratio, total protein, and total free immunoglobulin light chain excretion, serum electrolytes, and urine pH and specific gravity. There was no significant change in mean serum creatinine within a course of treatment, nor was there a cumulative increase in the serum creatinine. In 9 of 19 evaluable courses there was a small transient fall in glomerular filtration rate with prompt recovery. There was no cumulative decrease in glomerular filtration rate through 3 courses of treatment. Four of the patients with preexisting renal insufficiency suffered no significant additional nephrotoxicity. There was no tubular dysfunction demonstrable in any of the patients. This study represents the first prospective detailed examination of multiple parameters of renal function in patients treated with CPDD and reveals that the only parameter to show any change with this schedule of drug administration was the glomerular filtration rate.