Glutamine is an amino acid (AA) whose mission is carrying nitrogen. Abnormalities in protein and AA metabolism has been observed in patients with acute renal failure. Several clinical trials had showed abnormalities in plasma AA and its elimination in uremic environment. Moreover, renal failure disturbs hepato-splachnic circulation of glutamin, tyrosine and proline. Cisplatin is a key drug in the chemotherapy pharmacology, and the nephrotoxicity due to tubular injury, is one of its most important side effects, which sometimes is irreversible and leads to substitutive renal treatment. The goal of this work is to find predictive factors of renal failure secondary to cisplatin. Fifty four patients treated with cisplatin were studied. The plasma AA concentration and another plasmatic and urine parameters were measured in three different days after each pulse of chemotherapy. Plasma AA modifications through the pulses and reabsortion percentages of everyone were analysed too. Significant differences were observed in 13 AA reabsortion percentages and 16 plasmatic concentration. Glutamin concentration through the pulses was higher in 13 patients, (24%) who presented renal failure (Plasmatic glutamin concentration higher than 1000 mM/L at the third day after cisplatin administration was highly predictive value about getting renal failure, with significant difference from patients with o normal renal function. Others parameters analysed did not rise significant predictive values, so as it was not found relation between hyperaminoaciduria and renal function. It is concluded that cisplatin leads to renal failure in a 24% of this patients. Glutamin, concentrations higher than 1000 mM/L at the third day after cisplatin administration have a high predictive value about getting renal failure; so, it is suggested this could be a early marker of cisplatin nephrotoxicity before the serum creatinine is elevated, in order to get an early and suitable treatment of it.

La glutamina es un aminoácido encargado del transporte sanguíneo de nitrógeno. En pacientes que desarrollan insuficiencia renal se ha detectado alteración de los niveles plasmáticos de aminoácidos (AA) y alteración en su excreción urinaria. El cisplatino es un fármaco utilizado en quimioterapia, siendo la nefrotoxicidad uno de sus efectos secundarios más importantes. Con el objetivo de encontrar factores predictivos para el desarrollo de insuficiencia renal secundaria al cisplatino, se estudiaron 54 pacientes con diversos tumores en tratamiento con cisplatino, cuantificándose la concentración de AA y otros parámetros bioquímicos en plasma y en orina de 24 horas en tres días diferentes tras cada ciclo de quimioterapia. Se analizaron las variaciones de los AA plasmáticos a lo largo de los distintos ciclos de cisplatino y los porcentajes de reabsorción de cada uno de ellos. Se detectaron diferencias significativas a través de los ciclos en el porcentaje de reabsorción de 13 AA y en las concentraciones plasmáticas de 16. La concentración de glutamina a lo largo de los ciclos fue mayor en pacientes que desarrollaron insuficiencia renal. El valor de glutamina sérica > 1000 mM/L analizada el tercer día tras la administración de cisplatino fue altamente predictivo de desarrollar insuficiencia renal, con una diferencia significativa respecto a los pacientes que no la desarrollan. Se concluye que concentraciones superiores a 1000 mM/L de glutamina plasmática al tercer día tras la administración de cisplatino tienen un alto valor predictivo respecto al desarrollo de insuficiencia renal aguda.