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Nephroprotection by theophylline in patients with cisplatin chemotherapy: a randomized, single-blinded, placebo-controlled trial.
J Am Soc Nephrol 2005; 16(2):452-8JA

Abstract

The aim of the present study was to assess the possible prevention of cisplatin-induced impairment of GFR by theophylline in patients with various malignancies. The trial design was parallel, randomized, single blinded, and placebo controlled. Patients received cisplatin at a dosage of 50 mg/m(2) either combined with etoposide, ifosfamide, and epirubicin or with paclitaxel and 5-fluorouracil/folinic acid with the usual precautions, including a standard hydration scheme before application of cisplatin in both arms. In the control arm, placebo was administered; in the verum arm, patients received theophylline in a loading dose of 4 mg/kg intravenously over 30 min before cisplatin, followed by 0.4 mg/kg per min over a minimum of 6 h, and then 350 mg three times daily orally for 4 consecutive days after completion of chemotherapy. GFR of each patient was assessed by renal clearance of inulin within 3 d before and at day 5 after cisplatin chemotherapy. Despite usual precautions, patients in the placebo group had a 21% decrease (range, 11 to 31%) of inulin clearance after a single cycle of cisplatin-containing chemotherapy (92.9 +/- 3.4 versus 71.8 +/- 3.5 ml/min; P < 0.01). Patients who received theophylline had no deterioration of GFR (91.5 +/- 3.7 versus 90.0 +/- 3.8 ml/min; P > 0.05). No adverse effects have been observed during theophylline application. Conventional precautions such as hydration and osmotic diuresis cannot prevent a significant decrease of GFR after a single cycle of cisplatin-containing chemotherapy. The prophylactic application of theophylline as an intravenous loading dose and oral maintenance regimen may preserve kidney function in terms of GFR.

Authors+Show Affiliations

Department of Nephrology and Rheumatology, Georg-August-University, Robert-Koch Strasse 40, 37075 Göttingen, Germany. pbenoeh@gwdg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15590762

Citation

Benoehr, Peter, et al. "Nephroprotection By Theophylline in Patients With Cisplatin Chemotherapy: a Randomized, Single-blinded, Placebo-controlled Trial." Journal of the American Society of Nephrology : JASN, vol. 16, no. 2, 2005, pp. 452-8.
Benoehr P, Krueth P, Bokemeyer C, et al. Nephroprotection by theophylline in patients with cisplatin chemotherapy: a randomized, single-blinded, placebo-controlled trial. J Am Soc Nephrol. 2005;16(2):452-8.
Benoehr, P., Krueth, P., Bokemeyer, C., Grenz, A., Osswald, H., & Hartmann, J. T. (2005). Nephroprotection by theophylline in patients with cisplatin chemotherapy: a randomized, single-blinded, placebo-controlled trial. Journal of the American Society of Nephrology : JASN, 16(2), pp. 452-8.
Benoehr P, et al. Nephroprotection By Theophylline in Patients With Cisplatin Chemotherapy: a Randomized, Single-blinded, Placebo-controlled Trial. J Am Soc Nephrol. 2005;16(2):452-8. PubMed PMID: 15590762.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nephroprotection by theophylline in patients with cisplatin chemotherapy: a randomized, single-blinded, placebo-controlled trial. AU - Benoehr,Peter, AU - Krueth,Patricia, AU - Bokemeyer,Carsten, AU - Grenz,Almut, AU - Osswald,Hartmut, AU - Hartmann,Jorg T, Y1 - 2004/12/08/ PY - 2004/12/14/pubmed PY - 2005/6/29/medline PY - 2004/12/14/entrez SP - 452 EP - 8 JF - Journal of the American Society of Nephrology : JASN JO - J. Am. Soc. Nephrol. VL - 16 IS - 2 N2 - The aim of the present study was to assess the possible prevention of cisplatin-induced impairment of GFR by theophylline in patients with various malignancies. The trial design was parallel, randomized, single blinded, and placebo controlled. Patients received cisplatin at a dosage of 50 mg/m(2) either combined with etoposide, ifosfamide, and epirubicin or with paclitaxel and 5-fluorouracil/folinic acid with the usual precautions, including a standard hydration scheme before application of cisplatin in both arms. In the control arm, placebo was administered; in the verum arm, patients received theophylline in a loading dose of 4 mg/kg intravenously over 30 min before cisplatin, followed by 0.4 mg/kg per min over a minimum of 6 h, and then 350 mg three times daily orally for 4 consecutive days after completion of chemotherapy. GFR of each patient was assessed by renal clearance of inulin within 3 d before and at day 5 after cisplatin chemotherapy. Despite usual precautions, patients in the placebo group had a 21% decrease (range, 11 to 31%) of inulin clearance after a single cycle of cisplatin-containing chemotherapy (92.9 +/- 3.4 versus 71.8 +/- 3.5 ml/min; P < 0.01). Patients who received theophylline had no deterioration of GFR (91.5 +/- 3.7 versus 90.0 +/- 3.8 ml/min; P > 0.05). No adverse effects have been observed during theophylline application. Conventional precautions such as hydration and osmotic diuresis cannot prevent a significant decrease of GFR after a single cycle of cisplatin-containing chemotherapy. The prophylactic application of theophylline as an intravenous loading dose and oral maintenance regimen may preserve kidney function in terms of GFR. SN - 1046-6673 UR - https://www.unboundmedicine.com/medline/citation/15590762/Nephroprotection_by_theophylline_in_patients_with_cisplatin_chemotherapy:_a_randomized_single_blinded_placebo_controlled_trial_ L2 - http://jasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=15590762 DB - PRIME DP - Unbound Medicine ER -