Nephron
Original Paper
Renal Toxicity Mediated by Continuous Infusion of Recombinant lnterleukin-2Ponce P. · Cruz J. · Travassos J. · Moreira P. · Oliveira J. · Melo-Gomes E. · Gouveia J.Unidade de Cuidados Intensivos e Unidade de Oncologia do Hospital Cuf, Serviço de Patologia Clinica do Hospital S. Cruz, Lisbon, Portugal
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Article / Publication Details
Accepted: June 12, 1992
Published online: December 12, 2008
Issue release date: 1993
Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 0
ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)
For additional information: https://www.karger.com/NEF
Abstract
Interleukin-2 (IL-2), a potent lymphokine with antitumoral activity, was used in continuous intravenous infusion for 5 days (18,000,000 IU/m2/day) in 9 treatment cycles in 5 patients with metastatic colorectal carcinoma. During the infusion, patients received agressive fluid replacement titrated by invasive hemodynamic monitoring, aiming at a stable central volemia. Body weight went up an average of 4.5 kg in 5 days, mean arterial blood pressure dropped slightly from day 1 to day 5 (105.4 ± 11.6 to 86.1 ± 12.5 mm Hg, p < 0.05), systemic vascular resistance decreased from 1304.7 ± 242.1 to 871.7 ± 237.2 dyn/ s/cnr5 (p < 0.05), with stable pulmonary capillary wedge pressure, cardiac output and central venous pressure. The urinary output significantly dropped from 1.9 ± 1.2 to 0.2 ± 0.1 ml/min (p < 0.05) with very significant rises in serum creatinine from 76.0 ± 28.3 to 242.2 ± 144.9 μmol/l (0.86 ± 0.32 to 2.47 ± 1.64 mg/dl) and N-acetyl-β-D-glucosaminidase urinary activity from 4.97 ± 5.0 to 23.0 ± 12.1 U/l, and significant decrement of creatinine clearance (1.86 ± 0.65 to 0.29 ± 0.27 ml/s or Ill.5 ± 38.9 to 17.1 ± 16.6 ml/min) and urinary sodium (113.8 ± 78.3 to 9.0 ± 6.7 mmol/l). Urine sediment evolved from normal at day 1 to 9.0 ± 3.7 epithelial cells/mm3 and 6.9 ± 3.6 brown casts/mm3 (p = 0.001). We concluded that cancer treatment with IL-2 in continuous infusion, even with stable hemodynamics, induces an acute renal failure in most patients treated.
© 1993 S. Karger AG, Basel
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Article / Publication Details
Accepted: June 12, 1992
Published online: December 12, 2008
Issue release date: 1993
Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 0
ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)
For additional information: https://www.karger.com/NEF
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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