University of Medicine and Pharmacy Grigore T. Popa Iai, Iasi, Romania.
Int Urol Nephrol. 2023 May;55(5):1205-1209. doi: 10.1007/s11255-022-03418-8. Epub 2022 Dec 12.
Acute kidney injury (AKI) is a growing global health problem with increased mortality and morbidity. Cisplatin is achemotherapy drug first introduced in 1978, and since then, it became one of the most widely used and successful anti-cancer medication. However, there are risks associated with cisplatin administration, such as nephrotoxicity. Mechanisms of nephrotoxicity include proximal tubular injury, DNA damage, apoptosis, inflammation, oxidative stress, and vascular injury. Although various protocols are being used in clinical practice in nephrotoxicity prevention due to cisplatin, there are no clear guidelines regarding this approach. Most recommendations include hydration and avoiding additional nephrotoxic drugs. To prevent nephrotoxicity, future perspectives could rely on natural products, such as flavonoids or saponins or pharmacological products, such as aprepitant, but data are scarce in this direction. Repetitive administration of cisplatin could cause subclinical kidney injury, which over time, leads to chronic kidney disease (CKD). Therefore, more studies are needed to determine possible ways to prevent nephrotoxicity and avoid the burden of CKD worldwide.
急性肾损伤 (AKI) 是一个日益严重的全球健康问题，其死亡率和发病率都在上升。顺铂是一种化疗药物，于 1978 年首次推出，自那时以来，它已成为使用最广泛、最成功的抗癌药物之一。然而，顺铂给药存在风险，如肾毒性。肾毒性的机制包括近端肾小管损伤、DNA 损伤、细胞凋亡、炎症、氧化应激和血管损伤。尽管由于顺铂的存在，在临床实践中使用了各种方案来预防肾毒性，但在这方面没有明确的指南。大多数建议包括水化和避免使用其他肾毒性药物。为了预防肾毒性，未来的研究方向可能依赖于天然产物，如类黄酮或皂苷，或药理学产品，如阿瑞匹坦，但在这方面的数据很少。重复给予顺铂可能会导致亚临床肾损伤，随着时间的推移，会导致慢性肾脏病 (CKD)。因此，需要更多的研究来确定预防肾毒性和避免全球 CKD 负担的可能方法。
