Q&A: Researchers discuss how IV magnesium reduces kidney damage from cisplatin chemotherapy

Medical Xpress / Mass General Brigham / JAMA Oncology ^ | April 24, 2025 | Shruti Gupta et al

[ConservativeMind]

How would you summarize your study?

Cisplatin is a chemotherapy drug used globally for the treatment of several cancers; however, it is also highly toxic to the kidneys. Beyond general supportive measures, there is minimal data from clinical trials regarding preventive treatments for cisplatin-associated kidney damage.

Animal studies suggest magnesium may help the kidneys excrete cisplatin in the urine, thereby protecting the kidneys from damage. However, data from larger studies in humans is lacking.

What question were you investigating?

We examined whether receipt of IV magnesium on the same day as the first dose of IV cisplatin was associated with a reduced risk of cisplatin-associated kidney damage.

What approach did you use?

We collected data on 13,719 patients receiving their first dose of cisplatin between 2006–2022 across five major cancer centers in the U.S. Around 30% of them received IV magnesium. We then tested whether magnesium receipt was associated with a lower risk of cisplatin-associated kidney injury, ensuring we accounted for a detailed list of key potential confounding variables.

What did you find?

Patients who received IV magnesium had a 20% lower adjusted odds of developing kidney damage from cisplatin compared to those who did not receive IV magnesium. Our findings suggest that IV magnesium administration may reduce the incidence of cisplatin-associated kidney damage. These findings were similar across a number of subgroup and sensitivity analyses.

What are the implications and next steps?

Our findings suggest that patients may benefit from receiving IV magnesium prior to receiving IV cisplatin. Magnesium is cheap, safe, and readily available around the world. Further, its use in the context of prevention of cisplatin-associated kidney injury is well-supported by animal models.

[ConservativeMind]

You should ask for IV magnesium, if undergoing cisplatin cancer therapy, to protect your kidneys.

[ConservativeMind]

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[tired&retired]

What type of Magnesium?

[tired&retired]

Here is the link to the JAMA summary that contains a link to the full text of the article.

https://jamanetwork.com/journals/jamaoncology/fullarticle/2833151

[sauropod]

Bkmk

[icclearly]

As someone who spent three years on dialysis and came of without a transplant and now live with very low level of kidney function and had chemotherapy let me comment on this -- something I know about from experience.

If you suspect you fit the profile (kidney damage & chemotherapy), then for God's sake, don't buy a jug of magnesium in hopes it might help.

By all means, discuss this with your nephrologist who you are likely seeing regularly and get good medical advice specifically for your case.

Modern medicine is a great thing -- but not always right for your specific case. Don't make it worse.