JEANNA WELBORN, M.D.; FREDERICK J. MEYERS, M.D.; LOIS F. O'GRADY, M.D.
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To the editor: Hutchinson and associates (1) report a salt wasting nephropathy in 10% of patients with lung cancer treated with cisplatinum. We saw a similar occurrence in 1 of 25 patients on a phase-I trial using carboplatinum in refractory patients who had relapses with acute leukemia (2).
A 78-year-old man with acute nonlymphocytic leukemia had fever and volume depletion with orthostatic hypotension. His only medication was Tylenol. Admission sodium level was 128 mmol/L; potassium, 5.0 mmol/L; CO2, 21 mmol/L; and creatinine, 2.3 mg/dL. The urine sodium level was 19 mmol/L; urine osmolality, 370 mmol/kg; fractional excretion of sodium, 0.05%;
WELBORN J, MEYERS FJ, O'GRADY LF. Renal Salt Wasting and Carboplatinum. Ann Intern Med. ;108:640. doi: 10.7326/0003-4819-108-4-640_1
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Published: Ann Intern Med. 1988;108(4):640.
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