Identifying cisplatin-induced kidney damage in paediatric oncology patients

Pediatr Nephrol. 2018 Sep;33(9):1467-1474. doi: 10.1007/s00467-017-3765-6. Epub 2017 Aug 18.

Abstract

Cisplatin is one chemotherapeutic agent used to treat childhood cancer in numerous treatment protocols, including as a single agent. It is likely to remain in clinical use over the long term. However, cisplatin-related toxicities, including neurotoxicity and nephrotoxicity, are common, affecting treatment, day-to-day life and survival of such children. With one in 700 young adults having survived childhood cancer, patients who have completed chemotherapy that includes cisplatin can experience long-term morbidity due to treatment-related adverse reactions. A better understanding of these toxicities is essential to facilitate prevention, surveillance and management. This review article discusses the effect of cisplatin-induced nephrotoxicity (Cis-N) in children and considers the underlying mechanisms. We focus on clinical features and identification of Cis-N (e.g. investigations and biomarkers) and the importance of magnesium homeostasis and supplementation.

Keywords: Cisplatin; Magnesium; Nephrotoxicity; Oncology; Paediatrics; Tubular toxicity.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / diagnosis*
  • Acute Kidney Injury / prevention & control
  • Antineoplastic Agents / adverse effects*
  • Biomarkers / blood
  • Biomarkers / urine
  • Child
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects*
  • Cisplatin / pharmacokinetics
  • Drug Administration Schedule
  • Fluid Therapy / methods
  • Glomerular Filtration Rate
  • Humans
  • Kidney / drug effects
  • Kidney / pathology
  • Kidney / physiopathology*
  • Magnesium / administration & dosage
  • Magnesium / blood*
  • Magnesium / metabolism
  • Neoplasms / drug therapy
  • Renal Elimination / drug effects

Substances

  • Antineoplastic Agents
  • Biomarkers
  • Magnesium
  • Cisplatin