Effect of Silymarin Administration on Cisplatin Nephrotoxicity: Report from A Pilot, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial

Despite several introduced preventive modalities, cisplatin nephrotoxicity remains a clinical problem. Some in vitro and in vivo studies have addressed the protective effects of silymarin against cisplatin nephrotoxicity. This study evaluated the effects of silymarin administration on cisplatin neph...

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Published in:Phytotherapy research 2015-07, Vol.29 (7), p.1046-1053
Main Authors: Shahbazi, Foroud, Sadighi, Sanambar, Dashti-Khavidaki, Simin, Shahi, Farhad, Mirzania, Mehrzad, Abdollahi, Alireza, Ghahremani, Mohammad-Hossein
Format: Article
Language:English
Subjects:
Acute Kidney Injury - chemically induced
Acute-Phase Proteins - urine
Adult
cisplatin
Cisplatin - adverse effects
Creatinine - blood
Creatinine - urine
Double-Blind Method
Female
Humans
Kidney - drug effects
Kidney Function Tests
Lipocalin-2
Lipocalins - urine
Magnesium - urine
Male
Middle Aged
milk thistle
nephrotoxicity
Pilot Projects
Potassium - urine
Proto-Oncogene Proteins - urine
silymarin
Silymarin - pharmacology
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Summary:Despite several introduced preventive modalities, cisplatin nephrotoxicity remains a clinical problem. Some in vitro and in vivo studies have addressed the protective effects of silymarin against cisplatin nephrotoxicity. This study evaluated the effects of silymarin administration on cisplatin nephrotoxicity as the first human study. During this pilot, randomized, double‐blinded, placebo‐controlled clinical trial, the effect of oral silymarin 420 mg daily in three divided doses starting 24–48 h before the initiation of cisplatin infusion and continuing to the end of three 21‐day cisplatin‐containing chemotherapy courses on cisplatin‐induced renal electrolytes wasting and kidney function were assessed. Cisplatin‐associated acute kidney injury (AKI) occurred in 8% of the patients. Urine neutrophil gelatinase‐associated lipocalin to urine creatinine ratio (NGAL/Cr) and urinary magnesium and potassium wasting increased significantly after cisplatin infusion in both groups. Significant positive correlation was found between cumulative dose of cisplatin and urine NGAL/Cr after three courses of cisplatin infusion. Incidence of AKI and the magnitude of urinary magnesium and potassium wasting did not differ between silymarin and placebo groups. No adverse reaction was reported by silymarin administration. Prophylactic administration of conventional form of silymarin tablets could not prevent cisplatin‐induced urine electrolyte wasting or renal function impairment. Copyright © 2015 John Wiley & Sons, Ltd.
ISSN:0951-418X
1099-1573
DOI:10.1002/ptr.5345