title: Effect of Silymarin Administration on Cisplatin Nephrotoxicity: Report from A Pilot, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial.
abstract: Despite several introduced preventive modalities, cisplatin nephrotoxicity remains a clinical problem. Some in vitro and in vivo studies have addressed the protective effects of silymarin against cisplatin nephrotoxicity. This study evaluated the effects of silymarin administration on cisplatin nephrotoxicity as the first human study. During this pilot, randomized, double-blinded, placebo-controlled clinical trial, the effect of oral silymarin 420 mg daily in three divided doses starting 24-48 h before the initiation of cisplatin infusion and continuing to the end of three 21-day cisplatin-containing chemotherapy courses on cisplatin-induced renal electrolytes wasting and kidney function were assessed. Cisplatin-associated acute kidney injury (AKI) occurred in 8% of the patients. Urine neutrophil gelatinase-associated lipocalin to urine creatinine ratio (NGAL/Cr) and urinary magnesium and potassium wasting increased significantly after cisplatin infusion in both groups. Significant positive correlation was found between cumulative dose of cisplatin and urine NGAL/Cr after three courses of cisplatin infusion. Incidence of AKI and the magnitude of urinary magnesium and potassium wasting did not differ between silymarin and placebo groups. No adverse reaction was reported by silymarin administration. Prophylactic administration of conventional form of silymarin tablets could not prevent cisplatin-induced urine electrolyte wasting or renal function impairment.
authors: Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors: Foroud
authors: F
authors: Shahbazi
authors: Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors: Sanambar
authors: S
authors: Sadighi
authors: Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Simin
authors: S
authors: Dashti-Khavidaki
authors: Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors: Farhad
authors: F
authors: Shahi
authors: Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mehrzad
authors: M
authors: Mirzania
authors: Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Alireza
authors: A
authors: Abdollahi
authors: Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mohammad-Hossein
authors: MH
authors: Ghahremani
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000209:Acute-Phase Proteins / Q000652:urine; D000328:Adult; D002945:Cisplatin / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood / Q000652:urine; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine; D008274:Magnesium / Q000652:urine; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011188:Potassium / Q000652:urine; D011518:Proto-Oncogene Proteins / Q000652:urine; D012838:Silymarin / Q000494:pharmacology*
chemical_list: D000209:Acute-Phase Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D012838:Silymarin; D003404:Creatinine; D008274:Magnesium; D002945:Cisplatin; D011188:Potassium
keywords: cisplatin; milk thistle; nephrotoxicity; silymarin