Skip to 0 minutes and 11 secondsCisplatin. Cisplatin is also a chemotherapy with high excellence for a nephrotoxicity. So hydration is very important and for those patient to check and usually those patient may have a peak creatine level within about ten to two weeks. And after good hydration and treatment the patient will actually slowly recovered. And so those treatment as still includes hydration. So you see over face to nephrotoxicity induced by medication, the major treatment is actually prevention and then selecting the right patient to use those medications. And so but the one thing about cisplatin and as you need to also check patients magnesium level. Okay, so let's back to ARF treatment. Our goal of ARF therapy.

Skip to 1 minute and 22 secondsAs a first goal, limited further nephrotoxic events, and we allow our kidney to recover on its own. We actually don't have any good muscle to speed up the recover, but if we don't add further nephrotoxin. We can actually see if our patient their kidney can fight by themselves. And second goal is reduce further and consequence associated with ARF that's including other complications of from ARF. So there are some established ARF treatments and in their different situation is actually mostly we can see patient their renal function came back. But the mortality rate until now there is no such regimen to actually increase in mortality with ARF.

Skip to 2 minutes and 36 secondsSo mannitol, loop diuretics, dopamine, calcium channel blocker or a some of the treatment that we can used. So let's look at diuretics. And the choice for diuretics includes mannitol and the loop diuretics and of course furosemide so on of top list of our DOC And If a patient developed resistance to diuretics we have to see if there are any drugs that actually reduce renal blood flow. And how about a patient's volume status? If the patients is already volume depletion so how can you still use the diuretics to push those urine. So if patient have no adequate volume, we probably can not use diuretics.

Risk Factors for Cisplatin & Goal of therapy

In this step, Prof. Chen talks about Cisplatin, the goal, and benefits of therapies, and how to use diuretics.

First, Cisplatin is used in chemotherapy with high excellence for nephrotoxicity. Therefore, hydration is very important. After good hydration and the treatment, the patient will recover gradually.

Besides, the first goal of the therapy is to limit further nephrotoxic event and to allow the kidney to recover on its own. The second goal is to reduce further sequelae associated with ARF.

For diuretics, we should notice two things. If a patient develops resistance to diuretics, we need to see if there is any drug that reduces renal blood flow. Also, If a patient has volume depletion or has no adequate volume, we could not use diuretics.

Do you have any experience with patients who are resistant to diuretics?
How do you suggest the medication? Please share it below.

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This video is from the free online course:

Pharmacokinetics: Drug Dosing in Renal Disease

Taipei Medical University