A Case of Renal Salt Wasting Syndrome Induced by Cisplatin for Chemotherapy

Korean Journal of Nephrology 2011;30(1):80-83.

Hye Won Hwang, Shin Han Song, Seung Tae Han, Jae Seok Kim, Byoung Geun Han, Seung Ok Choi and Jae Won Yang.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

증례 : Cisplatin 항암요법 후 발생한 신성 염분소실 증후군 1예

황혜원, 송신한, 한승태, 김재석, 한병근, 최승옥, 양재원

연세대학교 원주의과대학 내과학교실

Abstract

Cisplatin is widely used for chemotherapy, but known to cause renal, auditory, hematologic, gastrointestinal, and neurologic toxicities. Hyponatremia after administration of cisplatin is related to renal tubular sodium excretion. A 71-year-old female was referred to our hospital for chemotherapy of laryngeal cancer. On admission, the patient’s laboratory data were normal. The patient received for 3 days chemotherapy without complication, but presented mental confusion on the 4th hospital day. The laboratory findings were as follows; serum sodium was 118 mmol/L, urine sodium 163 mmol/L, serum osmolality 248 mmol/kg, and urine osmolality 594 mmol/kg. On physical exam, volume status was hypovolemic, so we supplied hypertonic and isotonic salines. On the 9th hospital day, she showed normal sodium concentration and clear consciousness. After chemotherapy, we should make differential diagnosis between SIADH (syndrome of inappropriate antidiuretic hormone) and renal salt wasting syndrome according to the physical examination. We report a case of renal salt wasting syndrome with severe mental change after chemotherapy using cisplatin.

Key Words: Hyponatremia, Cisplatin, Chemotherapy