Journal of Maternal and Child Health (2022), 07(05): 609-617
Differences Levels of Sodium, Potassium, Calcium, and Magnesium Before and After Cisplatin Administration in Child with Osteosarcoma
Hendra Wardhana, Muhammad Riza, Husnia Auliyatul Umma
Department of Pediatrics, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta
Background: Cisplatin is one of the most commonly used cytostatic chemotherapy agents, especially in patients with solid tumors such as osteosarcoma. The exact mechanism of whether and how cisplatin causes electrolyte disturbances is still unclear. This study aims to determine the differences in levels of sodium, potassium, calcium, and magnesium with the administration of cisplatin in children with osteosarcoma.
Subjects and Method: This was an analytical retrospective study using secondary data in the form of medical records. The sample size in this study was calculated by the single proportion for¬mula. The population was children with osteosarcoma who had been given cisplatin che¬motherapy at Dr. Moewardi Hospital, Surakarta in January to March 2021. Total of 25 samples were included in this study. The variables studied included the administration of Cisplatin (independent variable) and electrolyte levels including sodium, magnesium, potassium and calcium (dependent variable). The research instrument used is medical records Data were analyzed using repated Anova test, Wilcoxon rank test, and post hoc test.
Results: There were differences and decreases in electrolyte levels before and after cisplatin administration in osteosarcoma patients, respectively: sodium (p <0.001), potassium (p= 0.002), calcium (p <0.001), and magnesium (p <0.001). The greatest decrease in electrolyte levels occurred in the fourth cycle after administration of cisplatin, respectively: sodium (mean= -4.44; p <0.001), potassium (Mean= -0.46; p= 0.002), calcium (Mean= -0.11, p <0.001), and magnesium (Mean= -0.07, p <0.001).
Conclusion: Cisplatin can interfere with electrolyte reabsorption in the renal tubules. Hypo-mag¬nesemia, hypokalemia, hypocalcemia and hyponatremia were found in children with osteosarcoma who received cisplatin. The decrease in electrolyte levels was greatest especially after undergoing the 4th cycle of chemotherapy. This was associated with repeated exposure in which the kidneys accumulated higher levels of cisplatin.
Keywords: osteosarcoma, cisplatin, electrolyte.
Correspondence: Hendra Wardhana. Department of Pediatrics, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Central Java, Indonesia. Jalan Kolonel Sutarto No. 132, Sura¬karta, Indonesia. Mobile: 082233413741. Email: firstname.lastname@example.org.