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Cisplatin is a potent chemotherapeutic agent that plays a key role in many cancer treatments. Unfortunately, it has many potentially serious side effects which often limit the amount of cisplatin that can be administered. One of these side effects is kidney toxicity. Usually, acute kidney failure resulting from cisplatin treatment indicates that the drug must be halted. However, the case of a 34-year-old man revealed that this may not necessarily be so. The patient developed abdominal pain and weight loss, and was found to have a large tumor in his back. Biopsy revealed the tumor to be a seminoma, a tumor that develops in men from germ cells. Cisplatin is generally the chemotherapeutic agent of choice for seminoma. The patient's tumor was measurably shrinking 41 days after the start of treatment when he developed septicemia. (Septicemia results from bacteria in the blood and, in this case, was most likely the result of a rectal biopsy.) The patient rapidly developed acute kidney failure which was believed to be due to the combined effects of cisplatin and septicemia. Intermittent dialysis was required. Ninety-three days after the start of cisplatin treatment, ultrasonic images revealed the recurrence of the cancer, as well as the appearance of a new tumor mass. It was decided to return the patient to cisplatin therapy while simultaneously placing him on dialysis. Mannitol and intravenous saline were administered in an effort to protect the kidneys from further damage during treatment. The patient was able to achieve a complete remission as a result of the cisplatin treatment and remains free of disease after three years. The patient's kidneys have recovered to useful function. While it would be unwise to generalize on the basis of this one observation, this case does illustrate that, when the patient's life may be at stake, acute kidney failure does not necessarily preclude further, and ultimately successful, treatment with cisplatin. (Consumer Summary produced by Reliance Medical Information, Inc.)