title: [Nephrotoxicity induced by repeated cycles of oxaliplatin in a Japanese colorectal cancer patient with moderate renal impairment].
abstract: There have so far been few reports of the pharmacokinetics of oxaliplatin in patients with renal impairment. This report describes the nephrotoxicity induced by repeated cycles of oxaliplatin in a Japanese colorectal cancer patient with moderate renal impairment(creatinine clearance(Ccr): 20-30mL/min). The patient was a 77-year-old male who had chronic renal impairment and received the modified FOLFOX6 repeated every 2 weeks. In cycle 8, the blood concentration of oxaliplatin(66 mg/m2)was measured as the platinum level to confirm the patient's safety. The serum ultrafiltrate concentrations of platinum were 800, 1, 000, 300, <200, and <200 ng/mLat 1, 2, 3 hr, 1 week, and 2 weeks after the start of infusion, respectively, which were closely comparable with the population pharmacokinetic data in Japanese patients with normal renal function. On the other hand, the serum creatinine value was gradually increased after cycle 6, resulting in a decrease of Ccr. The mean Ccr during day 1-59 and day 240-299were significantly different at 26. 5+/-2. 8(mean+/-SD)and 9. 6+/-1. 9mL/min, respectively. Consequently, the chemotherapy showed a complete response after 10 cycles, but the patient got dialysis on day 311. In conclusion, the repeated cycles of oxaliplatin cumulatively damaged the renal function in a Japanese patient with a moderate renal impairment.
authors.affiliation: Division of Pharmacy, Ehime University Hospital.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kawazoe
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kawazoe
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sugishita
authors.forename: Shinichi
authors.initials: S
authors.lastname: Watanabe
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tanaka
authors.forename: Jyunko
authors.initials: J
authors.lastname: Morioka
authors.forename: Katsuya
authors.initials: K
authors.lastname: Suemaru
authors.forename: Yuji
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Kanji
authors.initials: K
authors.lastname: Kawachi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Araki
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D044466:Asian People; D015179:Colorectal Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D003401:Creatine / Q000097:blood; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D000077150:Oxaliplatin; D006435:Renal Dialysis
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003401:Creatine; D002955:Leucovorin; D005472:Fluorouracil