Effect of Severe Renal Dysfunction on the Plasma Levels of DNA-Reactive Platinum after Oxaliplatin Administration

Shunsaku Nakagawa, Aimi Shimazaki, Taro Funakoshi, Atsushi Yonezawa, Shigeki Kataoka, Takahiro Horimatsu, Daiki Hira, Kotaro Itohara, Satoshi Imai, Takayuki Nakagawa, Takeshi Matsubara, Motoko Yanagita, Manabu Muto, Kazuo Matsubara, Tomohiro Terada

Research output: Contribution to journalArticlepeer-review


Higher amounts of circulating ultrafilterable platinum (fPt) are found in patients with renal dysfunction receiving a constant dose of oxaliplatin. However, the increased systemic fPt levels do not increase oxaliplatin-induced toxicities. We hypothesized that renal dysfunction has minimal effect on the elimination rate of reactive fPt, and that the DNA-binding capacity is one of the properties of reactive Pt species. This study aimed to quantify DNA-reactive fPt in plasma and to evaluate the impact of severe renal dysfunction on its pharmacokinetics. The pharmacokinetics of oxaliplatin was assessed in rats with bilateral nephrectomy (BNx) and in a hemodialysis patient who received mFOLFOX7 therapy for advanced metastatic gastric cancer. The platinum concentrations were determined using inductively coupled plasma-mass spectrometry. The amount of DNA-reactive fPt in the plasma was evaluated by the reaction between plasma and calf thymus DNA. Compared to the sham group in rats, the BNx group had significantly higher plasma total fPt concentrations at 24 h after drug administration. However, there was no significant difference in the plasma levels of DNA-reactive fPt between the two groups. In a hemodialysis patient, the plasma levels of total fPt decreased to 35.9 and 7.3% at 2 and 14 d after treatment, respectively. The plasma level of DNA-reactive fPt also decreased to 1.9 and 0.6%, respectively, on these days. This study showed that severe renal dysfunction has a limited effect on the plasma levels of DNA-reactive fPt after oxaliplatin administration.

Original languageEnglish
Pages (from-to)194-200
Number of pages7
JournalBiological and Pharmaceutical Bulletin
Issue number2
Publication statusPublished - 2023
Externally publishedYes


  • DNA-reactive platinum
  • dialysis
  • oxaliplatin
  • pharmacokinetics
  • renal dysfunction

ASJC Scopus subject areas

  • Pharmacology
  • Pharmaceutical Science


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