Renal tubular acidosis due to oxaliplatin.


Oxaliplatin is a third-generation platinum derivative which in combination with a fluoropyrimidine has demonstrated improved overall survival in metastatic colon cancer [1], prolonged progression free survival in an adjuvant setting [2] and prompted recommendations for its use by the National Institute for Clinical Excellence [3]. Initial studies with oxaliplatin did not identify significant renal toxicity but acute tubular necrosis (without dehydration) has been reported [4]. This is a case of a 53-year-old gentleman who developed severe renal tubular acidosis, probably secondary to oxaliplatin. Duke’s B adenocarcinoma of the transverse colon (pT4N0, stage II) was diagnosed following hemicolectomy for perforated bowel in 2002. After 6 months of adjuvant therapy with 5-flourouracil (425 mg/m on days 1–5, repeated every 28 days for 6 cycles), he re-presented in 2005 with weight loss and a solitary liver metastasis was identified by TELSA MRI and FDG PET-CT. He was commenced on neo-adjuvant oxaliplatin (130 mg/m on day 1 q21d) and capecitabine (1000 mg/m BD on days 1–14, q21d) before hepatic resection. On day 14 of the second cycle of oxaliplatin and capecitabine, he was admitted with a 7-day history of lethargy, anorexia, nausea, polyuria and increasing breathlessness. His oral intake had been 2–3 litres of salt lassi (pH 4) and three or four limes a day. He had a past Annals of Oncology letters to the editor

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@article{Linch2007RenalTA, title={Renal tubular acidosis due to oxaliplatin.}, author={Mark D Linch and David C. Cunningham and Olivia Mingo and Anquonette Stiles and W Paul Farquhar-Smith}, journal={Annals of oncology : official journal of the European Society for Medical Oncology}, year={2007}, volume={18 4}, pages={805-6} }