Evaluation of biochemistry and hemogram parameters during diagnosis and treatment and retrospective screening of the incidence of nephropathy of patients undergoing cisplatin-based chemotherapy follewed by oncology service and policlinic of Ege Univercity Medical Faculty internal medicine department

Cisplatin is a strong antineoplastic agent that is commonly used for treatment of solid tumors. The main side effects are nephrotoxicity, neurotoxicity, autotoxicity and bone marrow suppression. The best known dose restricting side effect is the development of nephrotoxicity despite intravenous saline infusion. In the previous studies, it was reported that; some of the patients using cisplatin for the first time developed reversible kidney injury, repetitive doses of cisplatin caused irreversible injury by increasing the occurrence and severity of renal impairment and toxicity of cisplatin was usually cumulative and dose dependent. The aim of this study was to determine hemogram and biochemical parameters, potential predictor factors that could be effective in the development of nephropathy and prevalence of nephropathy among cancer patients undergoing cisplatin-based chemotherapy during diagnosis and treatment. For this purpose the hospital records of 997 patients aged 18 years and over who admitted to Oncology Department of Internal Medicine of Ege University Faculty of Medicine between January 2014 and December 2014 were reviewed retrospectively and 158 cisplatin-based chemotherapy treatment planned patients were included to the study. A p value <0.05 was considered statistically significant. Most frequent diagnosis was gastric cancer and most commonly used treatment protocol was cisplatin-gemcitabine combination on patients undergoing cisplatin-based chemotherapy. Although not statistically significant, cumulative dose of cisplatin was higher in patients who developed acute or chronic renal impairment compared to ones who did not. Basal hemograms and biochemical parameters for 99 patients were available. It was determined while 55 patients did not develop AKI, AKI was developed in 44 patients and CKD was developed in 15 patients. Age at the time of diagnosis and death of the patients who had AKI were higher (p<0.05). In addition, PO4 values after the second cure of the patients who developed AKI were lower than who did not (p<0.05). NLR values of patients who developed CKD were higher compared to ones who did not develop CKD (p<0.05). Also after chemotherapy, serum total protein, uric acid and NLR values of individuals who developed CKD were higher compared to ones who did not develop CKD (p<0.05). Mg values of patients who developed CKD were lower at the onset time of AKI (p<0.05). Anemia was determined in patients who developed AKI and CKD. Prevention of cisplatin induced nephrotoxicity is quite important. Thus morbidity and mortality related renal failure might be decreased, duration of hospitalization would be shortened and cost of treatment would be reduced. Furthermore, coming into routine use of an agent which protects kidneys against cisplatin would allow usage of cisplatin as an effective antineoplastic agent without dose reduction in repetitive treatments and in higher doses. Key Words: Cancer, Cisplatin, Nephrotoxicity