During platinum-based chemotherapy, which laboratory measurements are most pertinent to assess nephrotoxicity risk?

• A. Amylase and lipase levels.
• B. Serum creatinine, eGFR, and magnesium/potassium levels to monitor for nephrotoxicity and electrolyte disturbances.
• C. Complete blood count and liver enzymes.
• D. Blood glucose and HbA1c.

Answer: (B)

Nephrotoxicity from platinum-based chemotherapy, especially cisplatin, is driven by damage to the kidneys’ ability to filter and reabsorb properly. The best way to detect and manage this risk is to closely monitor renal function and electrolytes. Serum creatinine and the estimated glomerular filtration rate reflect how well the kidneys are filtering waste, and rising creatinine or a decreasing eGFR signals decreasing kidney function that may require dose adjustments or supportive care. Magnesium and potassium levels are crucial to check because platinum drugs can cause tubular injury that wastes these electrolytes, leading to potentially serious imbalances if not treated. Together, these measurements let clinicians track kidney health and intervene early to prevent progression to significant nephrotoxicity.

Other labs like amylase/lipase assess pancreatic injury, while complete blood count and liver enzymes monitor hematologic or hepatic toxicity, and blood glucose/HbA1c relate to metabolic control. They do not directly target nephrotoxicity risk.