Review

Kidney International (2008) 73, 994–1007; doi:10.1038/sj.ki.5002786; published online 13 February 2008

Cisplatin nephrotoxicity: Mechanisms and renoprotective strategies

N Pabla1 and Z Dong1

1Department of Cellular Biology and Anatomy, Medical College of Georgia and Charlie Norwood VA Medical Center, Augusta, Georgia, USA

Correspondence: Z Dong, Department of Cellular Biology and Anatomy, Medical College of Georgia, 1459 Laney Walker Blvd, Augusta, Georgia 30912, USA. E-mail: zdong@mail.mcg.edu

Received 4 September 2007; Revised 18 October 2007; Accepted 30 October 2007; Published online 13 February 2008.

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Abstract

Cisplatin is one of the most widely used and most potent chemotherapy drugs. However, side effects in normal tissues and organs, notably nephrotoxicity in the kidneys, limit the use of cisplatin and related platinum-based therapeutics. Recent research has shed significant new lights on the mechanism of cisplatin nephrotoxicity, especially on the signaling pathways leading to tubular cell death and inflammation. Renoprotective approaches are being discovered, but the protective effects are mostly partial, suggesting the need for combinatorial strategies. Importantly, it is unclear whether these approaches would limit the anticancer effects of cisplatin in tumors. Examination of tumor-bearing animals and identification of novel renoprotective strategies that do not diminish the anticancer efficacy of cisplatin are essential to the development of clinically applicable interventions.

Keywords:

cisplatin, nephrotoxicity, renoprotection, apoptosis, inflammation

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