How soon should the creatinine be measured when dosing carboplatin (Paraplatin)? Our institution prefers that blood be drawn within 48 hours, but many times creatinine is not included in that lab work.

The point at which creatinine is measured is institution-based. However, carboplatin administration can result in loss of kidney function by more than 50%, as measured by creatinine clearance (Cancer: Principles & Practice of Oncology. 2008:37-38). Tests should be performed before the start of therapy and at periodic intervals throughout the course of therapy. Usually a full set of comprehensive labs, including CBC, liver function tests, and renal function tests (BUN and creatinine), are ordered before each subsequent cycle of treatment. The terminal half-life of carboplatin is 2.5 to 6 hours in normal renal function, and about 70% is renally excreted unchanged (Oncology Nursing Advisor. 2009:212-213). Close monitoring of renal function with therapies including carboplatin is pertinent to kidney preservation. — Jiajoyce R. Conway, DNP, FNP-BC, NP-C