LONG-TERM RENAL EFFECT OF CISPLATIN IN MAN

Although the acute nephrotoxicity of cisplatin has been well documente d, long-term follow-up studies are scanty. We have evaluated the renal function in 35 patients who have had completed therapy with cisplatin at least 3 months before the study. All patients had normal serum cre atinine levels before chemotherapy. Evaluation of renal function inclu ded: serum creatinine, glomerular filtration rate (inulin clearance), effective renal plasma flow (p-aminohippurate clearance), urinary beta (2)-microglobulin and N-acetyl-beta-D-glucosaminidase excretion, and r enal tomography. The median cumulated dose of cisplatin was 603 +/- 37 mg/m(2). The mean serum creatinine level was 78 +/- 21 and 88 +/- 3 m u mol/l before and after chemotherapy, respectively (p < 0.05). Mean g lomerular filtration rate (92 +/- 4 ml/min) and effective renal plasma flow (362 +/- 21 ml/min) were significantly lower than in controls (1 10 +/- 3 and 436 +/- 24 ml/min). The mean enzymuria and the renal size remained within the normal range. In 12 patients who were reevaluated 12 and 24 months later, glomerular filtration rate and effective rena l plasma flow remained stable. These results suggest that at usual dos ages cisplatin is associated with a nonprogressive loss of renal funct ion which is of a moderate degree.