Nephrotoxicity of CDDP assessed estimating glomerular filtration rate with 99mTc-DTPA plasma sample method.

ABSTRACT

OBJECTIVE: To assess early nephrotoxicity of CDDP (Cis-diamminedichloroplatinum) manifested by a decline in the glomerular filtration rate (GFR) estimated by plasma two sample clearance method (PSC 2) after 99mTc-DTPA injection. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY Department of Nuclear Medicine, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, from September 2004 to January 2005. METHODOLOGY: The renal function was assessed on 36 patients suffering from different types of cancer and receiving CDDP in doses of (3) 50 mg/m(2) before and after in each of six CDDP cycles. The GFR was determined by PSC 2 method after 99mTc-DTPA injection). A paired sample t-test was used for comparison of the mean value with significance at p < 0.01. RESULTS: There were (28 males and 8 females; age range being 16-68 years) The average decline in GFR baseline to the end of sixth cycles was 43.86 ml/min/1.73m(2) (p=0.000) as estimated by PSC 2 method. There was a significant fall of average 9.36 ml/min/1.73m(2) (p < 0.01) in GFR as observed in each cycle of CDDP estimated by the PSC 2 method. In the initial four cycles, CDDP produced a major nephrotoxic effect of average 10.27 ml/min/1.73m(2) (p < 0.01) fall in GFR. This then gradually declined to a plateau of an average decline in GFR of 7.76 and 7.31 ml/min/1.73m(2) (p=0.000) after the 5th and 6th cycle respectively. CONCLUSION: CDDP produced an early nephrotoxicity which was manifested by a significant decline in GFR in each cycle. Tc-99m PSC 2 method for GFR estimation should be used periodically for the early detection of nephrotoxicity induced by CDDP.