Abstract
Cisplatin including pre- and postoperative chemotheropy was carried out in 16 esophageal cancer patients and various renal functions were monitored after cisplatin administration in total 27 courses. Nephrotoxicity (≥grade 2) occurred in 37.5% of the cases inspite of massive fluid load with diuretics. Renal tubular dysfunction was the main body of nephrotoxicity by cisplatin, accompanied by mild glomerular dysfunction. Both functions were aggravated in the second course of chemotherapy. Hyponatremia (≥130 mEq/l) was observed in 44% of the cases, of which creatinine clearance was worse than that of non-hyponatremic cases. Plasma hormonal changes were monitored in five cases, where aldosteron tended to increase and atrial natriuretic peptide tended to decrease after cisplatin administration. Decrease in serum natrium and insufficient fluid load were conceived to be its reason. It is necessary to improve the infusion therapy regarding to a dose of sodium administration, infusion volume, and administration of plasma expander.
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