Nephrotoxicity of CDDP assessed estimating glomerular filtration rate with 99mTc-DTPA plasma sample method.

OBJECTIVE To assess early nephrotoxicity of CDDP (Cis-diamminedichloroplatinum) manifested by a decline in the glomerular filtration rate (GFR) estimated by plasma two sample clearance method (PSC 2) after 99mTc-DTPA injection. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Department of Nuclear Medicine, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, from September 2004 to January 2005. METHODOLOGY The renal function was assessed on 36 patients suffering from different types of cancer and receiving CDDP in doses of (3) 50 mg/m(2) before and after in each of six CDDP cycles. The GFR was determined by PSC 2 method after 99mTc-DTPA injection). A paired sample t-test was used for comparison of the mean value with significance at p < 0.01. RESULTS There were (28 males and 8 females; age range being 16-68 years) The average decline in GFR baseline to the end of sixth cycles was 43.86 ml/min/1.73m(2) (p=0.000) as estimated by PSC 2 method. There was a significant fall of average 9.36 ml/min/1.73m(2) (p < 0.01) in GFR as observed in each cycle of CDDP estimated by the PSC 2 method. In the initial four cycles, CDDP produced a major nephrotoxic effect of average 10.27 ml/min/1.73m(2) (p < 0.01) fall in GFR. This then gradually declined to a plateau of an average decline in GFR of 7.76 and 7.31 ml/min/1.73m(2) (p=0.000) after the 5th and 6th cycle respectively. CONCLUSION CDDP produced an early nephrotoxicity which was manifested by a significant decline in GFR in each cycle. Tc-99m PSC 2 method for GFR estimation should be used periodically for the early detection of nephrotoxicity induced by CDDP.