Effect of Mannitol Hydration as Renoprotective on Cisplatin Induced Nephrotoxicity (CIN) in Head and Neck Cancer Patients

Abstract

Background: Cisplatin is a cytostatic agent used as treatments in head and neck cancer patients.
Nephrotoxicity is one of cisplatin major side effects. This study aimed to evaluate the renoprotective
effect of mannitol-hydration administration in head and neck cancer patients who receive cisplatin
chemotherapy. Methods: This was a cohort observational study to analyze the renal function of head and
neck cancer patients who receives cisplatin before and after mannitol-hydration administration in IRNA
Surgery and Soekardja Room of Chemotherapy at RSUD Dr. Soetomo Surabaya during June – September
2018. The data obtained were BUN, SCr, and eClCr Cockroft-Gault of each cycle. Result: A total of 52
patients were evaluated. The average value of creatinine serum, creatinine clearance, and BUN at each cycle
were fluctuate. However, the average value of creatinine serum and BUN were within the normal limit.
The result of statistical analysis using paired t-test in those parameters at each cycle were not statistically
significant (p > 0,05) after mannitol administration except during first cycle to second cycle the SCr increased
significantly and eClCr was decreased significantly (p-value 0,024; 0,006, CI 95% respectively ). At fourth
cycle the eClCr also decreased significantly (p value 0,008, CI 95%). Conclusion: The renoprotective effect
of mannitol in head and neck cancer patients who receive cisplatin chemotherapy is sufficiently adequate
which can maintain the value of BUN and creatinine serum of patients at each cycle within the normal limit.