The Nephrotoxicity of Cisplatin

Cisplatin is a cancer chemotherapeutic agent whose cl inical use is complicated by i ts dose related kidney toxicity. Since the histopathological profi le of cisplatin nephrotoxicity appears similar to that of other heavy metals, i t has been commonly presumed that cisplatin nephrotoxicity is related to the platinum moiety. However, the delayed time course and development of cisplatin nephrotoxic i ty is not characteristic of heavy metal nephropathy. Furthermore, cisplatin nephrotoxicity is stereospecific to the cis and not the trans isomer, indicating that the platinum atom is not the proximate nephrotoxicant. I t is l ikely that a metabolite of cisplatin, possibly an aquated and/or hydroxylated complex, mediates the nephrotoxicity of cisplatin.