RESUMO
Cisplatin nephrotoxicity was evaluated by serial pretreatment and post-treatment 24-hour creatinine clearance determinations in 43 patients who received 295 monthly infusions of 60 mg/m2 of this drug. An aggressive standard hydration protocol was used without diuretic administration. Fourteen of these patients had a single kidney. Older patients and patients with a single kidney had lower pretreatment creatinine clearances when compared with younger persons with two functioning kidneys. Older and younger patients with two kidneys had an equal, progressive, dose-related deterioration of renal function. Renal function did not decline in persons with a single kidney but did so markedly in those with two kidneys. When administered at 60 mg/m2, cisplatin dose or schedule modification is not indicated on the basis of advancing age or decreased renal function secondary to the surgical loss or total ureteral obstruction of one kidney.
Assuntos
Envelhecimento , Cisplatino/efeitos adversos , Nefropatias/induzido quimicamente , Rim/efeitos dos fármacos , Neoplasias/tratamento farmacológico , Adulto , Idoso , Cisplatino/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A normally-virilized 24-year-old white man who had gynecomastia was found to have a Leydig-cell tumor of the testis, without demonstrable metastases. Hormonal evaluation revealed negative serum and urine tests for human chorionic gonadotropin, and normal steroid excretion. Prior to orchiectomy, serum estradiol was elevated and serum testosterone depressed; postoperatively these values reverted to normal. Attempts to quantitative the estradiol content of the tumor failed to show a significant increase over normal testicular tissue, however. Histologically, the tumor showed classic Reinke crystalloids, the nature of which remains undefined. Electron-microscopic studies showed these crystals to have a regular hexagonal pattern.
