The effect of cisplatin on renal function in Sudanese patients with malignant solid tumours attending the Nationa l Oncology Centre Kha rtoum - Sudan 1 June 1 995 - 30 Sep. 1996 .


Research type: Research Paper

Authors: Mukhtar, Fatima Mohamed Ahmed .

Abstract: This study was conducted between June 1995 to Sep. 1996. 41 Sudanese patients were selected from those attending the National Oncology Centre KHartoum, Sudan. Patients were of both sexes, aged between 11- 78 years, mean (49.7) SD (19.1), who presented with different types of malignant tumours, and were treated with cisplatin chemotherapy. 36 age and sex - matched controls were also included in the study. Cisplatin is an effective cytotix agent in many solid malignant tumours. Its use is limited by its nephrotoxicity. In this study nephrotoxicity of the drug using serum urea, electrolytes, creatinine and uric acid and creatinine clearance was evaluated. Also the validity of some formulae for calculating creatinine clearance with out 24 hour urine collection, using serum creatinine, age, body weight and surface area was also evaluted. The study showed that, there was no significant change in body weight following treatment. Blood pressure showed mild elevation after treatment but this was of no statistical significance. Urine analysis showed mild proteinuria (in makes 55.6 percent and in females 78.5 percent) in the majority of patients and some patients showed haematuria (in males 37 pecent and in females 50 percent) and casts (in males 37 percent and in females 42.9 percent) following cisplatin therapy. Serum electrolytes (Na+& K+) showed no significant changes. there was an elevation in serum uric acid but this was not statistically significant. Serum urea showed mild or no changes after treatment except in three patients who developed renal failure. Although there was an elevation of serum creatinine in all patients following treatment this was still within the normal range, except in those who developed significant renal failure. All patients had a decrease in creatinine clearance following treatment, but only three of them showed marked renal toxicity with serum urea less than 50 mg/dl, serum creatinine less than 2.5 mg/dl and creatinine clearance greater than 40 ml/min., and of these one patient died with serum creatinine less than 5.7 mg/dl, one showed improvement after cessation of treatment and the third patient disappeared. Younger patients tolerated the drug very well, one patient aged 21 years had 3 cycles of cisplatin with no clinical evidence of renal toxicity. Cockroft's & Gault's formula showed a good correlation with measured cratinine clearance both in male and female controls and patient, before treatment and following treatment. (In male controls 1= 0.83, male patients before treatment 1= 0.81 and male patients after treatment 1= 0.75. In female controls r = 0.83, female patients before treatment r = 0.73 and female patients after treatment r = 0.80). From the study, cisplatin was found to have mild nephrotoxicity, which is usually reversible, when given with good hydration and diuresis Cockroft's & Gault's formula for calculating creatinine clearance showed a good correlation with that measured by using 24 hour urine volume and may be used as a substitute for measured creatinine clearance. .