title: Protective effect of magnesium preloading on cisplatin-induced nephrotoxicity: a retrospective study.
abstract: OBJECTIVE
  Magnesium supplementation has been reported to have a nephroprotective effect on cisplatin-induced renal dysfunction, but little evidence exists regarding the effect of magnesium preloading before cisplatin administration. We started to include magnesium preloading (8 mEq) in cisplatin-containing treatment regimens in January 2011. The aim of the present study was to evaluate whether magnesium preloading reduces cisplatin-induced nephrotoxicity.
  
  
  METHODS
  We retrospectively reviewed 496 thoracic malignancy patients treated with cisplatin (≥60 mg/m²)-containing regimens as a first-time chemotherapy between January 2009 and December 2011. We compared the incidence of Grade ≥2 serum creatinine elevation according to the Common Terminology Criteria for Adverse Events, version 4.0, between magnesium preloading group (n = 161 [32%]) and non-magnesium preloading group (n = 335 [68%]) during the first cycle and all cycles.
  
  
  RESULTS
  The median number of administered cycles was four in both groups. The incidence of Grade ≥2 serum creatinine elevation in magnesium preloading group was significantly lower during both the first cycle and all cycles than in the non-magnesium preloading group (4.9 versus 19.1% during the first cycle, and 14.2 versus 39.7% during all the cycles). A multivariate analysis indicated that magnesium preloading significantly reduced cisplatin-induced nephrotoxicity throughout the entire period from after the first administration (odds ratio: 0.262, 95% confidence interval: 0.106-0.596 during the first cycle, and odds ratio: 0.234, 95% confidence interval: 0.129-0.414 during all cycles).
  
  
  CONCLUSIONS
  Magnesium preloading before cisplatin administration significantly reduced cisplatin-induced nephrotoxicity.
authors: *Division of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. siniho@east.ncc.go.jp.
authors: Tatsuya
authors: T
authors: Yoshida
authors: Seiji
authors: S
authors: Niho
authors: Mayuko
authors: M
authors: Toda
authors: Koichi
authors: K
authors: Goto
authors: Kiyotaka
authors: K
authors: Yoh
authors: Shigeki
authors: S
authors: Umemura
authors: Shingo
authors: S
authors: Matsumoto
authors: Hironobu
authors: H
authors: Ohmatsu
authors: Yuichiro
authors: Y
authors: Ohe
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood*; D004334:Drug Administration Schedule; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D008274:Magnesium / Q000008:administration & dosage* / Q000097:blood; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011322:Primary Prevention / Q000379:methods; D020011:Protective Agents / Q000008:administration & dosage*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D020011:Protective Agents; D003404:Creatinine; D008274:Magnesium; D002945:Cisplatin
keywords: cisplatin; magnesium; nephrotoxicity