How do you manage cisplatin nephrotoxicity?

The standard approach for prevention of CIN is the administration of lower doses of cisplatin in combination with full intravenous hydration prior and after cisplatin administration. Cisplatin-induced oxidative stress in the kidney may be prevented by natural antioxidant compounds.

Can cisplatin cause hyponatremia?

More common side effects of cisplatin include nephrotoxicity, anaphylaxis, and cytopenias. Hyponatremia is a rare complication associated with cisplatin. The mechanism by which it causes hyponatremia is thought to be due to either inducing SIADH or by renal salt wasting syndrome (RSWS) [1].

When do you take cisplatin and mannitol?

Conclusion The use of mannitol reduces the incidence and severity of nephrotoxicity in patients treated with cisplatin. The results of the study suggest mannitol may be most effective when used with non-gynecologic regimens and with cisplatin doses ≥70 mg/m2.

How is nephrotoxicity treated?

Nephrotoxicity from IL-2 is generally reversible and managed by administering fluid boluses at the onset of oliguria [95,96]. Additionally, vasopressors such as low and intermediate-dose dopamine are used in treatment of oliguria and hypotension by cross-talk with adrenergic receptors [97,98].

How do you reduce nephrotoxicity?

General preventive measures to avoid nephrotoxicity include using alternative nonnephrotoxic drugs; correcting risk factors; assessing baseline renal function before initiation of therapy, followed by adjusting the dosage; monitoring renal function and vital signs during therapy; and avoiding nephrotoxic drug …

What is renal salt wasting?

RSW is redefined as ‘extracellular volume depletion due to a renal sodium transport abnormality with or without high urinary sodium concentration, presence of hyponatremia or cerebral disease with normal adrenal and thyroid function.

Can multiple myeloma cause hyponatremia?

The hyponatremia found in multiple myeloma and which is associated with a reduced anion gap (ag) is considered to be pseudohyponatremia due to the displacement of water by the high globulin content in the blood.

Why is mannitol given with cisplatin?

Mannitol is an osmotic diuretic that increases urine output. It may be used before cisplatin to reduce the nephrotoxic effects of cisplatin. Not all institutions use mannitol for this purpose, and may use other methods such as administering prehydration and posthydration with saline and electrolytes.

What does mannitol do with cisplatin?

Mannitol is a compound that has been thought to help negate cisplatin-induced nephrotoxicity. Mannitol is a diuretic, causing increased amount of urination, enhancing excretion of cisplatin. Mmultiple studies that indirectly looked into the effect of mannitol in preventing kidney damage in patients receiving cisplatin.