Objective: To evaluate the nephrotoxicity of cisplatin in cancer patients, using different protocols of hydration. Study Design Randomized controlled trial. Patients & Methods: This study was conducted between 1st June to 30th November 2004. Ninety-nine patients with normal renal function 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 (100m1). 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. Results: 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: Conclusions: Hydration with saline and furosemide is less nephrotoxic than other protocols with cisplatin infusion.
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