CP-136 Mannitol 10% for the prevention of cisplatin induced nephrotoxicity: a comparison of concomitant mannitol 10% administration with cisplatin versus hydration alone

Background Cisplatin induced nephrotoxicity is a dose limiting adverse effect that occurs in nearly one-third of patients. Mannitol administration has been used as a means to negate this toxicity. Purpose The aim of this study was to evaluate the incidence of cisplatin induced nephrotoxicity in patients treated with and without mannitol. Specfically, the study tested if the addition of mannitol to cisplatin reduced signficantly the increase in serum creatinine from baseline and the incidence of acute nephrotoxicity. Material and methods This was a comparative prospective study. All eligible patients treated with cisplatin during the study period were enrolled in the study. All patients received 500 mL of normal saline (0.9%) infused over 1 hour prior to cisplatin therapy, and 1000 mL infused over 2 hours after cisplatin therapy. The mannitol group received 250 mL of mannitol 10% concomitant with the cisplatin dose, infused over 1 hour if the dose of cisplatin was <70 mg/m2 or over 3 hours if the dose of cisplatin was >70 mg/m2. The primary outcome was mean change in serum creatinine from baseline. Secondary outcomes included incidence of acute nephrotoxicity. Difference in the incidence of nephrotoxicity was compared using the Fischer exact test. The average change in serum creatinine was compared using the Student’s t-test. Statistical signficance was defined as p<0.05. All statistical analyses were done using SPSS (V.21). Results 35 patients (17 treated with mannitol and 18 without) were evaluated. The average increase in serum creatinine ( mg/dL) was 4.37 in patients who received mannitol and 5.41 in those who received hydration alone (p=0.39). In the group that received mannitol, 15.3% experienced nephrotoxicity while 33.2% of the patients in the hydration alone group experienced nephrotoxicity (p=0.44). Patients who received doses ≥80 mg/m2 of cisplatin had non-significantly lower rates of nephrotoxicity with mannitol (8% vs 13%; p=0.34). Conclusion There was no significant difference observed with regard to increase in serum creatinine from baseline and the incidence of acute nephrotoxicity between the two groups treated with and without mannitol. No conflict of interest