Cisplatin damages the renal tubule, causing a falling glomerular filtration rate and urinary loss of magnesium and potassium. Hypomagnesaemia worsens nephrotoxicity and can cause arrhythmias and seizures.
Before each weekly dose, check creatinine or eGFR, magnesium and potassium, and ask about tinnitus or hearing loss. Adequate pre- and post-hydration is essential. Avoid adding other nephrotoxins such as NSAIDs and aminoglycosides during treatment, and watch for vomiting that leads to dehydration.
- Check creatinine, magnesium and potassium before every cisplatin dose.
- Ensure pre- and post-hydration per protocol.
- Avoid NSAIDs and aminoglycosides during cisplatin treatment.
- Ask about tinnitus and hearing loss at each visit.
Why it matters
Missed cisplatin doses from kidney injury reduce the chance of cure in head and neck cancer.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for oncology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free