CISPLATIN-INDUCED NEPHROTOXICITY AND THE PROTECTIVE EFFECT OF FOSFOMYCIN ON IT AS DEMONSTRATED BY USING A CROSSOVER STUDY OF URINARY METABOLITE LEVELS

Background. Cisplatin induces nephrotoxicity and this study evaluated the protective effect of fosfomycin on it in 11 gynecological cancer p atients. Methods. The N-acetyl-beta-D-glucosaminidase (NAG), beta(2)-m icroglobulin (beta(2)MG), creatinine (uCr) and total protein (TP) leve ls in a 24-hour urine specimen as well as the blood urea nitrogen (BUN ) and serum creatinine (sCr) were measured before and after CAPF chemo therapy alone (control) or with fosfomycin. Results. The results were statistically analyzed by using the t-test. NAG, beta(2)MG, uCr and TP levels increased significantly after chemotherapy in the control pati ents, but BUN and sCr levels did not change significantly. The NAG lev el in the control group was twice as high as in the fosfomycin group 8 days after chemotherapy (p<0.01). The uCr and TP in control patients increased significantly after chemotherapy when compared to those in p atients coadministered fosfomycin. There were no significant changes i n beta(2)MG, BUN and sCr levels. Conclusions. Cisplatin affected the l evels of NAG, beta(2)MG, uCr and TP without influencing BUN and sCr le vels. Fosfomycin, therefore, may be useful as a supplemental treatment for reducing cisplatin nephrotoxicity, especially proximal tubular da mage.