Incidence and spectrum of electrolyte disturbances in cisplatin based chemotherapy

Anand, Aravindh Sivanandan; Nikhil, S

doi:10.18203/2320-6012.ijrms20151450

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…Based on table 3 it can be concluded that the greatest decrease in potassium levels occurred in cycle 4. This is in line with previous findings, namely in the Journal of Research in Medical Science in 2015 which revealed that the most common electrolyte disturbances found due to cisplatin administration were hypokalemia as well as hypomagnesaemia (Anand, 2015).…”

Section: Discussionsupporting

confidence: 93%

Differences Levels of Sodium, Potassium, Calcium, and Magnesium Before and After Cisplatin Administration in Child with Osteosarcoma

Wardhana

Riza²,

Umma³

2022

J MATERN CHILD HEALTH

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Background: Cisplatin is one of the most commonly used cytostatic chemotherapy agents, especially in patients with solid tumors such as osteosarcoma. The exact mechanism of whether and how cisplatin causes electrolyte disturbances is still unclear. This study aims to determine the differences in levels of sodium, potassium, calcium, and magnesium with the administration of cisplatin in children with osteosarcoma. Subjects and Method:This was an analytical retrospective study using secondary data in the form of medical records. The sample size in this study was calculated by the single proportion formula. The population was children with osteosarcoma who had been given cisplatin chemotherapy at Dr. Moewardi Hospital, Surakarta in January to March 2021. Total of 25 samples were included in this study. The variables studied included the administration of Cisplatin (independent variable) and electrolyte levels including sodium, magnesium, potassium and calcium (dependent variable). The research instrument used is medical records Data were analyzed using repated Anova test, Wilcoxon rank test, and post hoc test. Results: There were differences and decreases in electrolyte levels before and after cisplatin administration in osteosarcoma patients, respectively: sodium (p <0.001), potassium (p= 0.002), calcium (p <0.001), and magnesium (p <0.001). The greatest decrease in electrolyte levels occurred in the fourth cycle after administration of cisplatin, respectively: sodium (mean= -4.44; p <0.001), potassium (Mean= -0.46; p= 0.002), calcium (Mean= -0.11, p <0.001), and magnesium (Mean= -0.07, p <0.001). Conclusion:Cisplatin can interfere with electrolyte reabsorption in the renal tubules. Hypomagnesemia, hypokalemia, hypocalcemia and hyponatremia were found in children with osteosarcoma who received cisplatin. The decrease in electrolyte levels was greatest especially after undergoing the 4th cycle of chemotherapy. This was associated with repeated exposure in which the kidneys accumulated higher levels of cisplatin.

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Section: Discussionsupporting

confidence: 93%

Differences Levels of Sodium, Potassium, Calcium, and Magnesium Before and After Cisplatin Administration in Child with Osteosarcoma

Wardhana

Riza²,

Umma³

2022

J MATERN CHILD HEALTH

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“…In particular, among platinum-derived drugs, cisplatin-induced hyponatremia occurred in 50% of the patients after a median critical dose of 195 mg at cycle 2, while higher cumulative doses had to be administered to observe hypokalemia (560 mg at cycle 7). Median critical doses for development of hypomagnesemia and hypocalcemia in 50% of the patients were 160 mg and 240 mg at cycle 2 and 3, respectively, supporting the concept of a lower dose required to induce hypomagnesemia versus others ion disorders (35). Table 2 shows the electrolyte disorders observed in patients treated with Alkylating agents.…”

Section: Antineoplastic Drugs Platinum-derived Compoundsmentioning

confidence: 71%

“…Platinum-derived agents can induce hypokalemia due to renal K wasting secondary to hypomagnesemia. The incidence of cisplatin-related hypokalemia is around 27% (35). Intracellular magnesium depletion reverts inactivation of voltage-dependent renal outer medulla K channels (ROMK), thus increasing kaliuresis.…”

Section: Antineoplastic Drugs Platinum-derived Compoundsmentioning

confidence: 99%

“…Hypomagnesemia is the most frequent electrolyte alteration caused by cisplatin and is related to its cumulative dose (50). Hypomagnesemia is associated with shorter survival (35,50), and its incidence ranges between 56 and 90% of patients receiving cisplatin, being lower with carboplatin (22,23,(37)(38)(39). It is mainly related to an impaired Mg reabsorption in the proximal tubule.…”

Section: Antineoplastic Drugs Platinum-derived Compoundsmentioning

confidence: 99%

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Electrolyte Disorders Induced by Antineoplastic Drugs

et al. 2020

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The use of antineoplastic drugs has a central role in treatment of patients affected by cancer but is often associated with numerous electrolyte derangements which, in many cases, could represent life-threatening conditions. In fact, while several anti-cancer agents can interfere with kidney function leading to acute kidney injury, proteinuria, and hypertension, in many cases alterations of electrolyte tubular handling and water balance occur. This review summarizes the mechanisms underlying the disturbances of sodium, potassium, magnesium, calcium, and phosphate metabolism during anti-cancer treatment. Platinum compounds are associated with sodium, potassium, and magnesium derangements while alkylating agents and Vinca alkaloids with hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion (SIADH). Novel anti-neoplastic agents, such as targeted therapies (monoclonal antibodies, tyrosine kinase inhibitors, immunomodulators, mammalian target of rapamycin), can induce SIADH-related hyponatremia and, less frequently, urinary sodium loss. The blockade of epidermal growth factor receptor (EGFR) by anti-EGFR antibodies can result in clinically significant magnesium and potassium losses. Finally, the tumor lysis syndrome is associated with hyperphosphatemia, hypocalcemia and hyperkalemia, all of which represent serious complications of chemotherapy. Thus, clinicians should be aware of these side effects of antineoplastic drugs, in order to set out preventive measures and start appropriate treatments.

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