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Prevalence and Preventive Strategies of Nephrotoxicity in Patients Receiving Cisplatin Based Regimen in a Kenyan Referral Hospital

Author: Mwai G.O. , Nyamu D.G. , Menge T.B. , Karimi P.N.
Is Part Of: Pharmaceutical Journal of Kenya, Volume 22, No. 3 (2015)
Cisplatin administration is associated with nephrotoxicity. There is scant literature on the renal toxicity profiles and their preventive strategies in Kenyatta National Hospital. A retrospective cohort study design was used to study the nephrotoxicity profiles and preventive strategies among three hundred and sixty seven adult patients in Kenyatta National Hospital’s radiotherapy clinic.
There was female preponderance of 62.6%. The median age of the study population was 51 years (ranging from 18-91). Prevalence of renal toxicities was found to be 58.5%, mostly grade 2 nephrotoxicity, with mean glomerular filtration rate of 59.3 ml/min/1.73m2 (±20.6). At a patient’s fifth visit, the odds ratio of developing grade three nephrotoxicity was twice as compared to the first visit (p=0.008). Postponement of doses of cisplatin retarded progression of nephrotoxicity in terms of deranged renal functions (p<0.0001). Medication change from cisplatin to carboplatin (p=0.181) and hydration with normal saline (p=0.486), however, did not prevent nephrotoxicity.
More than half of the patients exhibited nephrotoxic profiles despite employing preventive strategies suggesting that better ways of preventing nephrotoxicity ought to be sought.

Keywords: Cisplatin, Nephrotoxicity, Preventive Strategies, Normal Saline.
Publisher: The Pharmaceutical Society of Kenya