A randomised study comparing intermittent to continuous administration of magnesium aspartate hydrochloride in cisplatin-induced hypomagnesaemia

Vokes, E.; Vogelzang, N. J.; Geiser, R; Douglas, Frank L.

doi:10.1038/bjc.1990.429

Cited by 15 publications

(5 citation statements)

References 17 publications

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“…Hypomagnesemia has been repeatedly confirmed by several studies. Additionally, Vokes, et al demonstrated a high incidence of hypomagnesemia in cisplatin-treated head and neck cancer patients and its relation to the cumulative cisplatin dose [ 4 ]. A study using rats has shown a substantial additive effect of magnesium-depletion on renal toxicity induced by cisplatin.…”

Section: Introductionmentioning

confidence: 99%

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

Kimura

Ozawa

Hanai

et al. 2018

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundOur study analyzes the effect of magnesium supplementation on nephrotoxicity in patients receiving cisplatin for head and neck cancer.MethodsWe 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.ResultsSixty-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).ConclusionWe demonstrated that an intravenous hydration regimen supplemented with magnesium prevented cisplatin-induced nephrotoxicity in patients with head and neck cancer.

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Section: Introductionmentioning

confidence: 99%

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

Kimura

Ozawa

Hanai

et al. 2018

Journal of Otolaryngology - Head & Neck Surgery

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“…In particular, depletion of magnesium has emerged as a common event associated with the acute renal toxicity induced by the drug [6] . Whereas several studies have demonstrated the efficacy of magnesium supplementation for prevention of hypomagnesemia during cisplatin treatment [7] – [10] , only two prospective studies, each featuring a relatively small number of patients, have evaluated its efficacy in terms of protection against cisplatin-induced nephrotoxicity [11] , [12] . Despite the dearth of evidence in support of a beneficial effect of magnesium supplementation therapy on the renal toxicity of cisplatin, intravenous administration of magnesium is currently recommended for outpatients receiving high-dose cisplatin with a short hydration regimen [13] .…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Cisplatin-Induced Nephrotoxicity and Potential of Magnesium Supplementation for Renal Protection

et al. 2014

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BackgroundNephrotoxicity remains a problem for patients who receive cisplatin chemotherapy. We retrospectively evaluated potential risk factors for cisplatin-induced nephrotoxicity as well as the potential impact of intravenous magnesium supplementation on such toxicity.Patients and MethodsWe reviewed clinical data for 401 patients who underwent chemotherapy including a high dose (≥60 mg/m2) of cisplatin in the first-line setting. Nephrotoxicity was defined as an increase in the serum creatinine concentration of at least grade 2 during the first course of cisplatin chemotherapy, as assessed on the basis of National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. The severity of nephrotoxicity was evaluated on the basis of the mean change in the serum creatinine level. Magnesium was administered intravenously to 67 patients (17%).ResultsCisplatin-induced nephrotoxicity was observed in 127 patients (32%). Multivariable analysis revealed that an Eastern Cooperative Oncology Group performance status of 2 (risk ratio, 1.876; P = 0.004) and the regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) (risk ratio, 1.357; P = 0.047) were significantly associated with an increased risk for cisplatin nephrotoxicity, whereas intravenous magnesium supplementation was associated with a significantly reduced risk for such toxicity (risk ratio, 0.175; P = 0.0004). The development of hypomagnesemia during cisplatin treatment was significantly associated with a greater increase in serum creatinine level (P = 0.0025). Magnesium supplementation therapy was also associated with a significantly reduced severity of renal toxicity (P = 0.012).ConclusionsA relatively poor performance status and the regular use of NSAIDs were significantly associated with cisplatin-induced nephrotoxicity, although the latter association was marginal. Our findings also suggest that the ability of magnesium supplementation to protect against the renal toxicity of cisplatin warrants further investigation in a prospective trial.

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“…Treatment of hypomagnesaemia related to treatment with cisplatin has been directed towards normalisation of P-Mg with the secondary intention to restore total body Mg (Macaulay et al, 1982;Vokes et al, 1990;Evans et al, 1995). However, P-Mg is evidently not a reliable indicator of Mg depletion during cisplatin chemotherapy, and neither can Mg substitution be guided by this parameter alone.…”

Section: Discussionmentioning

confidence: 99%

Severe intracellular magnesium and potassium depletion in patients after treatment with cisplatin

et al. 2003

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The purpose of this study is (1) to evaluate skeletal muscle magnesium (Mg) and potassium (K) during treatment with cisplatin; (2) to evaluate the predictive value of plasma (P)-Mg for intracellular Mg during cisplatin treatment; and (3) to evaluate whether changes in intracellular K influence skeletal muscle Na,K-ATPase. In all, 65 patients had a needle muscle biopsy obtained before and 26 patients both before and after cisplatin treatment. Biopsies were analysed for Mg, K, and Na,K-ATPase concentrations, and P-Mg and P-K determined. Treatment with a total dose of E500 mg (270 mg [K] were not associated with changes in the muscle Na,K-ATPase concentration. Following treatment with cisplatin, an E15% decline in P-Mg was accompanied by an E15% loss of muscle [Mg], as well as an E10% reduction of muscle [K] and fatigue and muscle weakness previously ascribed to hypomagnesaemia may therefore also be well explained by muscle K depletion observed despite normal levels of P-K. There was no correlation between P-Mg and SM-Mg or between P-K and SM-K. Thus, P-Mg and P-K are not reliable indicators for Mg and K depletion during treatment with cisplatin. However, the majority of patients will present Mg and K depletion after cisplatin therapy and of these only very few patients will present a low P-Mg or P-K. Therefore, routine supplementation should be considered in all patients receiving cisplatin.

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A randomised study comparing intermittent to continuous administration of magnesium aspartate hydrochloride in cisplatin-induced hypomagnesaemia

Cited by 15 publications

References 17 publications

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

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

Risk Factors for Cisplatin-Induced Nephrotoxicity and Potential of Magnesium Supplementation for Renal Protection

Severe intracellular magnesium and potassium depletion in patients after treatment with cisplatin

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