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Clinically silent progressive renal tubulointerstitial disease during cisplatin chemotherapy
Author(s) -
Guinee Donald G.,
Van Zee Bruce,
Houghton Donald C.
Publication year - 1993
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19930615)71:12<4050::aid-cncr2820711240>3.0.co;2-7
Subject(s) - medicine , nephrotoxicity , cisplatin , renal biopsy , kidney disease , chemotherapy , nephropathy , pathology , urology , creatinine , kidney , biopsy , gastroenterology , endocrinology , diabetes mellitus
Background . Chronic cisplatin nephrotoxicity is well documented in animal models but not well characterized in humans. The authors report a 56‐year‐old woman who had end‐stage chronic tubulointerstitial nephropathy develop during treatment with multiple courses of cisplatin chemotherapy for ovarian carcinoma. Methods . A biopsy was performed to determine the etiology of renal failure, and the morphologic, immunofluorescent, and ultrastructural findings are reported. The clinical history and morphologic findings were analyzed to identify possible causes, other than cisplatin, of chronic renal disease. Results . Morphologic studies showed extensive renal tubulointerstitial fibrosis with relative sparing of glomeruli. Conclusions . Profound, progressive renal injury occurred during cisplatin treatment despite adherence to treatment protocols designed to minimize such toxicity. Renal injury was undetected by pretreatment serum creatinine determinations. This case and others emphasize the relative insensitivity of this test for chronic renal damage during treatment with nephrotoxic drugs.