Why is hydration with aggressive IV fluids sometimes with mannitol essential when using cisplatin?

• A. To reduce nephrotoxicity
• B. To prevent hypertension
• C. To enhance tumor uptake
• D. To prevent alopecia

Answer: (A)

Protecting the kidneys from cisplatin’s toxicity by keeping the kidneys well perfused and producing a high urine flow is the key idea. Cisplatin is cleared by the kidneys and tends to accumulate in the proximal tubule cells, where it can cause inflammation and cell injury leading to acute kidney damage. Giving aggressive IV fluids increases renal blood flow and urine production, which helps dilute the drug and lowers its concentration in the tubules. Adding mannitol, an osmotic diuretic, further boosts diuresis, speeding the clearance of cisplatin from the tubular lumen and reducing the time the drug spends in contact with renal cells.

That’s why this approach is used—to minimize nephrotoxicity. It isn’t primarily about preventing hypertension, enhancing tumor uptake, or preventing hair loss, which aren’t addressed by hydration and osmotic diuresis in this context.