- Design
- Randomised controlled trial, four arms
- Population
- 100 patients with head and neck SCC on weekly cisplatin and radiotherapy
- Primary outcome
- Urinary and serum kidney injury biomarkers
- Effect
- Lower urinary KIM-1 and NGAL with magnesium (P < 0.05)
An Egyptian trial randomised 100 patients with newly diagnosed head and neck squamous cell carcinoma, all having weekly cisplatin 40 mg/m² with radiotherapy for seven cycles, to no magnesium or to 1 g, 2 g or 3 g of intravenous magnesium sulphate with each cycle.
Magnesium groups had lower urinary KIM-1 and NGAL, markers of tubular injury, than controls. The 3 g group also had lower serum soluble Fas ligand and malondialdehyde. Clinical renal outcomes such as creatinine-defined kidney injury or dose reductions were not reported in the abstract.
Magnesium supplementation with cisplatin is already common because cisplatin wastes magnesium. This trial suggests a possible protective effect on the tubule, but only through biomarkers, so it supports existing practice rather than changing it.
- Check serum magnesium, creatinine and electrolytes before each cisplatin cycle
- Replace magnesium as per your oncology protocol
- Ensure adequate pre- and post-hydration with cisplatin
- Watch for hypomagnesaemia-related arrhythmia and tetany
Why it matters
Supports routine magnesium with cisplatin in a setting where head and neck cancer is common, including India.
Don't overread it
Only surrogate biomarkers were reported; it does not show fewer clinical kidney injuries.
The statistics, in plain English
KIM-1 and NGAL are early markers of kidney tubule injury; lower levels are encouraging but are surrogate endpoints. With 25 patients per arm, the trial is too small to show differences in clinical kidney injury.
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