Mechanistic impact of medicinal plants affecting cisplatin-induced nephrotoxicity; an overview

Abstract

Cisplatin is a powerful chemotherapy drug that is administered to treat a wide range of cancers. However, its clinical use is limited due to kidney damage and the reduction in glomerular filtration rate that occurs in 15 to 30 of patients. Several mechanisms lead to renal dysfunction after cisplatin administration, including direct damage to proximal tubular epithelial cells that causes necrosis and apoptosis. Cisplatin administration is accompanied by the production of reactive oxygen species (ROS), which causes lipid peroxidation, proteins and nucleic acids oxidation, cell membrane degradation, and finally reduction in glomerular filtration. The most prominent effect of cisplatin-induced nephrotoxicity (CIN), which can be progressive, is hypomagnesemia, Fanconi syndrome and anemia. Cisplatin nephrotoxicity is more prominent in individuals who received higher doses of this drug, or in patients who had previous chemotherapy regimen and presence of renal dysfunction. This paper is sought to describe cisplatin nephrotoxicity and the protective role of medicinal plants in preventing the renal toxicity. In this regard, the role of antioxidants will be specifically addressed.