An integrative view of the pathophysiological events leading to cisplatin nephrotoxicity.

Cisplatinis among the most effective chemotherapeutic agents against solid tumors. Nephrotoxicityis the most common side effect of cisplatinchemotherapy, which limits the clinical use of cisplatinand seriously worsens the quality of life of cancer patients resulting in dosage reduction and discontinuation of treatment. Cisplatininvolves a complex multifactorial process, as it has direct toxic effect on cells of the renal tubules, vasculature and glomeruli, and causes alterations in renal blood flowand glomerular filtration rate. Indirectly, cisplatinalso induces inflammation of the renal interstitium, which contributes to the acute damage and may lead to chronic interstitial fibrosis, indicative of irreversible renal damage. This review presents an integrative view of the pathophysiological effects of cisplatinon tubular, vascular, glomerular, and interstitial function and the interplay among these actions. Moreover, it reviewed human clinical trials of the last ten years in order to evaluate the ...