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Comparative Study
. 2018 Feb 2;47(1):10.
doi: 10.1186/s40463-018-0261-3.

Renal protective effect of a hydration supplemented with magnesium in patients receiving cisplatin for head and neck cancer

Takahiro Kimura  1   2 , Taijiro Ozawa  3 , Nobuhiro Hanai  2 , Hitoshi Hirakawa  4 , Hidenori Suzuki  2 , Hiroshi Hosoi  1 , Yasuhisa Hasegawa  5
Affiliations
Comparative Study

Renal protective effect of a hydration supplemented with magnesium in patients receiving cisplatin for head and neck cancer

Takahiro Kimura et al. J Otolaryngol Head Neck Surg. .

Abstract

Background: Our study analyzes the effect of magnesium supplementation on nephrotoxicity in patients receiving cisplatin for head and neck cancer.

Methods: We retrospectively reviewed the medical records of patients with head and neck cancer who received two doses of cisplatin (80 mg/m2) and 5-fluorouracil (800 mg/m2) 3 weeks apart from August 2008 to October 2012. The regimen prior to 2011 (crystalloid-only) involved the administration of 1000 mL of lactated Ringer's solution on the day prior to cisplatin infusion and 2000 mL of continuous infusion of saline on the day of cisplatin infusion. The regimen after 2011 (magnesium-supplemented) did not involve hydration on the day before cisplatin administration but used 1000 mL of 0.9% saline with magnesium sulfate (20 mEq) administered for 3 hours before cisplatin infusion.

Results: Sixty-five patients were treated with the crystalloid-only regimen and 56 patients with the magnesium-supplemented regimen. The mean creatinine clearance in the magnesium-supplemented group decreased by 4.9 mL/kg/min, whereas that in the crystalloid-only group decreased by 15.0 mL/kg/min after two courses. In multivariate analysis, only magnesium-supplemented hydration was an independent predictive factor for preventing cisplatin-induced nephrotoxicity (odds ratio = 0.157, 95% confidence interval 0.030-0.670, P = 0.0124).

Conclusion: We demonstrated that an intravenous hydration regimen supplemented with magnesium prevented cisplatin-induced nephrotoxicity in patients with head and neck cancer.

Keywords: Cisplatin; Head and neck cancer; Magnesium; Nephrotoxicity.

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The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Change of hydration regimen in our study. In both regimens, dexamethasone (8 mg), granisetron (1 mg), and furosemide (20 mg) were given before cisplatin (CDDP) infusion. Post hydration was performed for 3 days with two liters of Soldem 3A® (Na 35 mEq/L, K 20 mEq/L, L-lactae 20 mEq/L, glucose 43.0 g/L)
Fig. 2
Fig. 2
a Change in creatine clearance in the regimen groups after two courses (*p < 0.0001 Student’s t-test). b The crystalloid-only regimen group was divided into with and without aprepitant groups. Change in creatine clearance in the magnesium-supplemented regimen group and crystalloid-only group with and without aprepitant after one course (†p = 0.0298 Student’s t-test). c Change in creatine clearance in the three groups after two courses (‡p < 0.0001, §p = 0.0026 Student’s t-test). ∆Ccr, difference in creatine clearance between chemotherapy courses
See this image and copyright information in PMC

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