The ability of mannitol to decrease cisplatin-induced nephrotoxicity in children: real or not?

Abstract

Appropriate hydration remains the main fundamental strategy for reducing the risk of cisplatin-induced nephrotoxicity. In conventional treatment regimens employing doses of cisplatin of less than 100 mg/m(2) in patients with normal renal function, pre- and post-hydration (3 l/m(2) at least 12 h pre-cisplatin and 24 h post-cisplatin) alone should be routinely used. In higher doses, pre- and post-hydration plus mannitol should be considered in order to ensure a valid diuresis.

Potential of morin and hesperidin in the prevention of cisplatin-induced nephrotoxicity

“…6,7 Besides the positive effects of cisplatin on cancer treatment, it can lead to many different complications including nephrotoxicity, neurotoxicity, ototoxicity, and emetogenicity. 8,9 Cisplatin-treated patients show nephrotoxicity (25-42%). 8 Nephrotoxicity occurs by renal toxic effects of cisplatin, but the underlying mechanism is not fully understood.…”

“…6 It is proposed that renal cell injury is related to the drug accumulated in kidneys (renal tubular cells), causing direct inflammation, generation of reactive oxygen species (ROS), DNA damage, mitochondrial dysfunction, and apoptosis. 5,6,9,10 Despite large number of studies about this topic, none of them is proved to be completely effective. For example, selenium, melatonin, vitamins C and E, mannitol, and arjunolic acid may be used to prevent or attenuate cisplatin-induced nephrotoxicity.…”

Cisplatin‐induced nephrotoxicity in patients with advanced neuroblastoma

“…Studies of long‐term survivors have indicated that drug‐induced nephrotoxicity may persist for long periods, even after the treatment . Various interventions, including extensive hydration, mannitol treatment, and continuous infusions of cisplatin, have been attempted to reduce the risk of this complication . However, it appears difficult to completely prevent nephrotoxicity.…”

Salt suppresses IFNγ inducible chemokines through the IFNγ-JAK1-STAT1 signaling pathway in proximal tubular cells

“…On the other hand, many clinical studies have indicated that salt loading ameliorates proximal tubular injury, such as contrast-induced nephropathy and cisplatin-induced nephrotoxicity89. In actual fact, saline hydration therapy is the clinical cornerstone for the prevention of contrast-induced nephropathy and cisplatin-induced nephrotoxicity1011. These past studies differ in the type of fluid used for hydration, thereby revealing that hydration using a higher salt concentration, regardless of fluid osmolality, has a greater protective effect.…”