ABSTRACT
To evaluate the nephrotoxicity of cisplatin in cancer patients, using different protocols of hydration. Randomized controlled trial. This study was conducted between 1st June to 30th November 2004. Ninety-nine patients with normal renal Junction were enrolled in the study and randomly assigned into the 3 study groups, each group having 33 patients. In group 1 hydration was done with saline [2 liter] alone, in group 2 with saline [2 liter] and furosemide [40mg] and in group 3 with saline [2 liter] and mannitol [100ml]. All 3 group patients were given cisplatin infusion 100 mg/m2 over 1 hour and the cycles repeated every 21-28 days. Twenty four hour creatinine clearance was measured before and after 6th day of the chemotherapy in all patients. For the first cycle of chemotherapy the 24-hour urinary creatinine clearance before chemotherapy for saline group was 95.54 +/- 15.27, for saline and furosemide group 98.43 +/- 13.44 and for saline and mannitol group 97.45 +/- 14.05 ml/min and after 6th day of cisplatin infusion was 77.4 +/- 14.59 for saline group, 86.06 +/- 11.9 for saline and furosemide group and 82.29 +/- 13.64 for saline and mannitol group. The reduction in creatinine clearance was less with saline and furosemide group [12.6%] as compared to saline and mannitol group [15.6%] and saline alone [18.9%] which is statistically significant. Each patient in these 3 study groups received many courses of cisplatin and showed the similar pattern. Hydration with saline and furosemide is less nephrotoxic than other protocols with cisplatin infusion