Why do you give mannitol with cisplatin

A case-control study was performed. Conditional logistic regression was used to identify baseline predictors of cisplatin-induced acute nephrotoxicity. Of the included patients, had nephrotoxicity and were matched controls. Univariable analysis showed that diabetes, baseline eGFR, and baseline magnesium level were significantly associated with nephrotoxicity, whereas mannitol dosing did not show any association odds ratio [OR] 1. In multivariable analysis, diabetes OR 1.

Age, diabetes, cisplatin dose per cycle, mannitol dose per cycle, baseline eGFR, and baseline magnesium level were not predictors for severity of nephrotoxicity. Cisplatin-induced acute nephrotoxicity remains common despite preventive measures in patients with good baseline renal function. Diabetes is a predictor of nephrotoxicity, whereas mannitol dosing has no significant influence, suggesting that doses may be standardized across cisplatin regimens.

Data regarding the efficacy of mannitol use in this context are conflicting and limited. Objective The aim of this study is to evaluate the effect of mannitol on renal function and describe the incidence of cisplatin-induced nephrotoxicity.

The primary outcome was mean change in serum creatinine from baseline. Secondary outcomes included incidences of various grades of nephrotoxicity. Given the duration of action of mannitol, as long as the premedications are administered sufficiently early, administration sequence relative to mannitol does not seem likely to impact clinical outcomes.

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