항암제 Cisplatin ( cis-diamminedichloroplatinum II ) 이 백서 신장에 미치는 영향에 관한 연구 = The Effect of Cisplatin ( cis-diamminedichloroplatinum II ) on Renal Function and Structures in Rats

다국어 초록 (Multilingual Abstract)

Cisplatin (cis-diamminedichloroplatinum II) is a new anticancer drug containing a heavy metal, platinum. Cisplatin shows a broad spectrum of antitumor activities in certain human cancers including gynecologic malignancies such as ovarian carcinoma. The clinical trial with cisplatin has shown moderate therapeutic benefits but also has significant toxic effects. The major toxic effects are impairment of renal function, myelosuppression, hearing loss and gastrointestinal disturbance. Of which these toxic effects, the renal toxicity is most serious dose limiting factor in clinical use. The nephrotoxicity of cisplatin has been well documented clinically, but the renal pathologic findings in patients treated with this drug have been scarce and not well demonstrated in the literature. In this study, renal toxicity is investigated in rats following a single intraperitoneal injection of cisplatin 6mg/kg, as acute experimental group and repeated treatments with cisplatin(1mg/kg twice weekly and 2mg/kg twice weekly for 11 weeks) as chronic experimental group. The results are as follows: A. Acute experimental group. 1. The mean kidney to body weight ratio is significantly greater in experimental group than controls on day 7. 2. Serum levels of BUN and creatinine rise to peak level on the 5th day and uric acid on the 7th day. On the 10th day, serum levels of creatinine and uric acid decreased to control level, but those of BUN are still greater than controls. 3. Histologic changes are characteristically confined to the corticomedullary region, straight tubules of outer zones of the medulla. Necrosis of the tubular cells is maximal on the 5th day, tubular dilatation is mostly severe on the 7th day and regeneration begins on the 10th day. B. Chronic experimental group. 1. The kidney to body weight ratio is greater than controls. 2. In rats treated with 1mg/kg of cisplatin, the mean BUN values are 6-fold greater and mean creatinine and uric acid values are 2-fold greater than controls. 3. Massive tubular dilatation in the corticomedullary region and interstitial fibrosis are noted. In conclusion, chronic use of cisplatin in cancer patients could cause irreversible renal damage.