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Evaluation of the effect of acetazolamide versus mannitol on cisplatin-induced nephrotoxicity, a pilot study

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Abstract

Background Cisplatin-induced nephrotoxicity still occurs despite the intensive hydration approach adapted to prevent its occurrence. Objective Evaluation of the effect of acetazolamide (ACTZ) on minimizing cisplatin-induced nephrotoxicity compared to mannitol when added to hydration regimen. Setting Nasser Institute Cancer Center (NICC), Cairo, Egypt. Method A total of 35 patients planned to receive cisplatin were divided into two groups: 20 patients received mannitol and 15 patients received ACTZ. Both groups received standard hydration measures as well for prevention of cisplatin-induced nephrotoxicity. Main outcome measure Patients’ kidney function was assessed using serum creatinine, creatinine clearance and blood urea nitrogen. Kidney injury was assessed using RIFLE criteria. Patients’ liver function tests and hematological parameters were also monitored. Results Patients in the mannitol group showed higher risk of developing kidney injury (30%) whereas those in the ACTZ group showed lower risk (8.9%), relative risk (RR) 0.269, 95% CI 0.108–0.815. No statistically significant difference occurred between the two groups concerning liver function tests or hematological parameters. Conclusion Use of ACTZ in addition to intensive hydration may have more beneficial effect on minimizing cisplatin-induced nephrotoxicity compared to mannitol plus intensive hydration approach. A large multicenter randomized clinical trials is recommended to confirm study results and to assess effect of ACTZ on tumor response.

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The datasets generated during and/or analyzed during the current study are available from the corresponding author on request.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. King Abdulaziz University, Jeddah, Saudi Arabia

    Manal El Hamamsy

  2. Faculty of Pharmacy, Ain Shams University, Cairo, Egypt

    Manal El Hamamsy

  3. Nasser Institute Hospital, Cairo, Egypt

    Noha Kamal

  4. Critical Care Medicine Department, Cairo University Hospitals, Giza, Egypt

    Naglaa Samir Bazan

  5. Clinical Oncology Department, Faculty of Medicine, Cairo University, Giza, Egypt

    Mostafa El Haddad

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  1. Manal El Hamamsy
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  2. Noha Kamal
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Correspondence to Noha Kamal.

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El Hamamsy, M., Kamal, N., Bazan, N.S. et al. Evaluation of the effect of acetazolamide versus mannitol on cisplatin-induced nephrotoxicity, a pilot study. Int J Clin Pharm 40, 1539–1547 (2018). https://doi.org/10.1007/s11096-018-0677-x

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  • DOI: https://doi.org/10.1007/s11096-018-0677-x

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