Ghorbani Ali, Omidvar Bita, Parsi Abazar
Department of Nephrology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Rheumatology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
J Nephropathol. 2013 Apr;2(2):129-34. doi: 10.12860/JNP.2013.21. Epub 2013 Apr 1.
Renal injury is common following cisplatin infusion. Some agents have been used to attenuate cisplatin nephrotoxicity. However, except hydration, none of them has been proved to be effective.
In this study selenium as an antioxidant supplement was tested on cisplatin induced renal injury.
122 cancerous patients (85 male and 37 female; age range of 14 to 82 years old) were enrolled to receive chemotherapy regimens consisting cisplatin. They were allocated into two groups using a random number list . Investigators, patients and analyzers all, were blinded in allocation by using sealed opaque envelopes. Intervention group received a single 400 mcg selenium tablet and patients in control group took a placebo tablet which was similar with selenium preparation in color, weight, shape and taste. Primary end points were an increase in plasma creatinine above 1.5 mg/dl in men and 1.4mg/dl in women, or increase of plasma creatinine more than 50% from baseline or urine flow rate less than 0.5 ml/kg/h. Creatinine level was measured initially and on the 5th day after cisplatin therapy.
There was no difference in cumulative dose of cisplatin between the groups (p=0.54). There were not evidences of acute renal failure (ARF) in cases. While, among placebo group, 7 patients had criteria of acute kidney injury. Conclusions :selenium could probably prevent cisplatin-induced acute kidney injury, when it is added to hydration therapy in cancerous patients.
顺铂输注后肾损伤很常见。一些药物已被用于减轻顺铂的肾毒性。然而,除了水化治疗外,没有一种药物被证明是有效的。
在本研究中,测试了作为抗氧化剂补充剂的硒对顺铂诱导的肾损伤的作用。
122例癌症患者(85例男性和37例女性;年龄范围为14至82岁)入选接受含顺铂的化疗方案。使用随机数字列表将他们分为两组。研究者、患者和分析者在分组时均通过使用密封不透明信封进行盲法分配。干预组接受一片400微克的硒片,对照组患者服用一片安慰剂片,其在颜色、重量、形状和味道上与硒制剂相似。主要终点是男性血浆肌酐升高至1.5mg/dl以上且女性升高至1.4mg/dl以上,或血浆肌酐较基线升高超过50%,或尿流率低于0.5ml/kg/h。在顺铂治疗开始时和治疗后第5天测量肌酐水平。
两组之间顺铂的累积剂量没有差异(p=0.54)。病例中没有急性肾衰竭(ARF)的证据。然而,在安慰剂组中,有7例患者符合急性肾损伤的标准。结论:在癌症患者的水化治疗中添加硒可能预防顺铂诱导的急性肾损伤。