Division of Nephrology, Lahey Hospital and Medical Center, Burlington, MA.
Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Semin Nephrol. 2022 Nov;42(6):151341. doi: 10.1016/j.semnephrol.2023.151341. Epub 2023 May 12.
Cisplatin is a highly effective chemotherapeutic agent that has been used for more than 50 years for a variety of cancers; however, its use is limited by toxicity, including nephrotoxicity. In this in-depth review, we discuss the incidence of cisplatin-associated acute kidney injury, as well as common risk factors for its development. Cisplatin accumulates in the kidney tubules and causes AKI through various mechanisms, including DNA damage, oxidative stress, and apoptosis. We also discuss the spectrum of nephrotoxicity, including acute and chronic impairment of kidney function, electrolyte disturbances, and thrombotic microangiopathy. We discuss the limited options for the diagnosis, prevention, and management of these complications, along with factors that may impact future therapy with or without cisplatin. We conclude with directions for future research in this expanding and important area.
顺铂是一种高效的化疗药物，已被用于治疗多种癌症超过 50 年；然而，其应用受到毒性的限制，包括肾毒性。在本次深入综述中，我们讨论了顺铂相关性急性肾损伤的发生率，以及其发生的常见危险因素。顺铂在肾小管中蓄积，并通过多种机制导致 AKI，包括 DNA 损伤、氧化应激和细胞凋亡。我们还讨论了肾毒性的范围，包括急性和慢性肾功能损害、电解质紊乱和血栓性微血管病。我们讨论了这些并发症的诊断、预防和治疗的有限选择，以及可能影响未来顺铂治疗或不治疗的因素。我们在这个不断发展和重要的领域为未来的研究指明了方向。
