シスプラチン投与後の血清クレアチニン値上昇に関する調査

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Cisplatin is a platinum compound used in solid tumor treatment. A dose limiting factor in cisplatin treatment is renal function disorder. Hydration is performed as a precaution at the time of cisplatin dosage. However, a most appropriate hydration method has yet to be established. Therefore, we investigated the serum creatinine rise in patients after cisplatin therapy to clarify an effective hydration method and risk factors of renal function disorder. We administered the treatment of 266 cycles in 111 patients who had received chemotherapy including more than 60 mg/m2 cisplatin in the past. We investigated the infusion solution used for hydration, various patient criteria factors and serum creatinine changes before and after cisplatin dosage. As a result, no significant difference was recognized in age, sex, diuretic dosage, and treatment cycles. However, a significant difference in the ratio of the patients was seen in those whose serum creatinine level increased at an Na load less than 371 mEq (odds ratio: 3.141, 95% confidence interval: 1.174-8.407, p=0.017), whose serum creatinine before the treatment was at more than 85.5% of the normal range upper limit value (4.481, 1.310-15.317, 0.012) and whose cisplatin dose was more than 60.1 mg/m2 (3.565, 1.117-12.493, 0.041). We infer that these are risk factors for a serum creatinine rise with the cisplatin treatment. Providing Na in excess of 371 mEq in hydration seems to be an effective precaution of the renal function disorder.