Cisplatin の腎毒性に関する実験的研究(持続静注法の腎障害予防効果について)

Abstract

家兎を対象として検討した.1) CDDP 3 mg/kgの1回投与の場合には, 持続静注ではmannitol利尿と同程度の腎障害予防効果が認められた.2) CDDP 6 mg/kgの大量投与の場合には, 持続静注とmannitol利尿の併用でのみ腎障害予防効果が認められ, 他の投与法では程度の差はあるものの十分な効果は得られなかった.3) CDDP 3 mg/kgの週1回, 5週間の反復投与の場合には, 持続静注ではmannitol利尿と同程度あるいはそれ以上の腎障害予防効果が認められた.また, 持続静注とmannitol利尿の併用では, 腎障害予防効果が最も著明であった

To evaluate the preventive effect of continuous infusion on the nephrotoxicity of high-dose cisplatin (CDDP), the renal function was monitored in rabbits treated with this antineoplastic agent in various modes of administration. 131I-hippuran uptake of the renal cortical slices and histopathological examination as well as serum creatinine and BUN levels were used as parameters for assessing renal damage. When CDDP was administered at a dose of 3 mg/kg, continuous infusion showed a similar effect in the reduction of nephrotoxicity to the obtained from rapid infusion with mannitol diuresis. For the large dose of 6 mg/kg, only the combination of continuous infusion and mannitol diuresis significantly reduced the nephrotoxicity. When 3 mg/kg of CDDP was serially given once a week for 5 consecutive weeks, continuous infusion produced a similar or even more beneficial effect compared to rapid infusion with mannitol diuresis and maximum effect was observed in continuous infusion with concomitant mannitol diuresis. In conclusion, continuous infusion produced a similar effect compared to rapid infusion with mannitol diuresis and maximum effect was observed in continuous infusion with concomitant mannitol diuresis.