[Prophylactic effect of fosfomycin on CDDP nephrotoxicity].
From 1985 to 1986, cisplatin (CDDP) therapy was performed 61 times in 24 patients with urological cancer. Thirty nine courses used fosfomycin (FOM) 4 g/day from the day before CDDP administration to the last dose of CDDP, and we statistically evaluated the prophylactic effect of FOM on CDDP nephrotoxicity using urinary NAG and FENa as parameters (t-test). In the 1-day CDDP group (CDDP 60-70 mg/m2 x 1 day) with FOM a peak NAG was seen on the 1st day but no significant NAG change, FENa has a peak on the 1st day, no significant increase between the previous and the 1st day, but a significant decrease was seen between the 3rd and the 5th day (p less than 0.05). In the 5-day CDDP group (CDDP 20 mg/m2 x 5 day) NAG reached a peak level on the 5th day with FOM, showed significant increase (p less than 0.05; between the previous and the 5th day) and decrease (p less than 0.01; between the 6th and the 14th), compared to those without FOM. FENa change tended to be similar, showing a significant increase, (p less than 0.05; between the 2nd and 4th) and decrease (p less than 0.05; between the 4th and 7th) with FOM but no significant change without FOM. NAG changes with FOM were classified by pre-CDDP dose creatinine clearance (Ccr, ml/min) into 3 groups (under 50, 50-100, over 100). In the 1-day CDDP group with any Ccr no significant NAG change obtained, but, in the 5-day CDDP group with 50-100 Ccr seen a NAG peak on the 6th day, significant increase (p less than 0.05; between the previous and the 6th) and decrease (p less than 0.05; between 6th and 12th). With over 100 Ccr NAG has 4th day peak, significant increase (p less than 0.05; between the previous and the 4th), and decrease (p less than 0.05; between 4th and 8th). A prophylactic effect of FOM on CDDP nephrotoxicity was found in the 5-day CDDP group not in the 1-day CDDP group, using urinary NAG and FENa. PVB and single CDDP regimen (5 day CDDP group) with FOM can be performed safely, if the pre-CDDP dose Ccr is over 50.
Yogi
S
S
Department of Urology, Fujigaoka Hospital, Showa University.
Ikeuchi
T
T
Kai
Y
Y
D000118:Acetylglucosaminidase / Q000652:urine; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002945:Cisplatin / Q000009:adverse effects*; D003404:Creatinine / Q000652:urine; D005260:Female; D005578:Fosfomycin / Q000627:therapeutic use*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control*; D007684:Kidney Tubules / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D012964:Sodium / Q000652:urine; D014571:Urologic Neoplasms / Q000188:drug therapy
D005578:Fosfomycin; D012964:Sodium; D003404:Creatinine; D000118:Acetylglucosaminidase; D002945:Cisplatin