Evaluation of the Effect of Acetazolamide, Mannitol and N-acetylcysteine on Cisplatin-Induced Nephrotoxicity

Abstract

Cisplatin is an important anti-cancer medication used for treatment for variety of malignant tumors. The most important toxicity caused by cisplatin is nephrotoxicity. Cisplatin-induced nephrotoxicity still occurs despite intensive hydration, reduction in glomerular filtration occurs in in approximately 30% of patients including acute renal failure and chronic renal insufficiency. Evidence that mannitol may have protective effect against cisplatin-induced nephrotoxicity is not clear. This is due to conflict showed by studies in animals and clinical trials. These trials have contradicting results that mannitol may or may not have protective effect against cisplatin-induced nephrotoxicity. Acetazolamide (ACTZ) and N-acetylcysteine (NAC) ameliorated Cisplatin-induced nephrotoxicity in rats. No study to date evaluated the protective effect of acetazolamide or NAC against cisplatin nephrotoxicity in humans. Current study was conducted to evaluate both the efficacy and safety of ACTZ or NAC against cisplatin nephrotoxicity in humans compared to mannitol and to each other.