ACUTE RENAL-FAILURE AFTER CIS-DICHLORODIAMMINEPLATINUM(II) AND GENTAMICIN-CEPHALOTHIN THERAPIES

  • 1 January 1978
    • journal article
    • research article
    • Vol. 62  (5) , 693-698
Abstract
Combined gentamicin-cephalothin therapy in 4 patients after treatment with cis-dichlorodiammineplatinum(II) (CPDD) for advanced solid tumors was complicated by severe acute renal failure. The total dose of gentamicin varied 240-945 mg and that of cephalothin varied 28-48 g. Low-dose (0.5 mg/kg 8) CPDD was given to 1 patient, high-dose (3 mg/kg) CPDD was given to 2 patients and very high-dose (5 mg/kg) CPDD was given to 1 patient. The high and very low doses of CPDD were given concomitant with mannitol diuresis. CPDD therapy was complicated by mild transient azotemia in 3 patients and severe acute renal failure in 1. In the latter, the azotemia began to improve on day 7 after CPDD treatment. Following gentamicin-cephalothin therapy, all patients developed severe acute renal failure which persisted until death. At autopsy, all patients had extensive renal tubular necrosis at various stages. These findings indicate that gentamicin-cephalothin therapy after treatment with CPDD can be severely nephrotoxic, and this antibiotic combination should be given with great caution, if at all, to patients receiving CPDD treatment for malignancy.