Cisplatin has a broad-spectrum antineoplastic activity. Nephrotoxicity is a prominent component of the toxicity profile of cisplatin-based chemotherapy. In recent years, several reports have confirmed that cystatin C (cys-C) demonstrates a better correlation with the glomerular filtration rate than with serum creatinine. Scintigraphic techniques are also widely used in evaluating renal function. In the present study, serum cys-C, serum creatinine concentrations and (99m)Technetium-mercaptoacetyltriglycine-3 (Tc-99m-MAG-3) scintigraphy were studied in 22 cisplatin-naive cancer patients, 3 days before and 24 h after the first cycle of cisplatin-based chemotherapy. Serum cystatin C and creatinine levels increased in cancer patients after chemotherapy (creatinine: from 68 +/- 12 to 72 +/- 17 mumol/L; cystatin-C: from 0.064 +/- 0.025 to 0.072 +/- 0.033 mumol/L), but these differences were not statistically significant (P > 0.05). Semiquantitative variables of Tc-99m-MAG-3 scintigraphy significantly elevated after chemotherapy (T-1/2*: from 10.27 +/- 5.00 to 16.17 +/- 9.40 min, R20/max*: from 0.40 +/- 0.12 to 0.67 +/- 0.45, Tmax**: from 5.40 +/- 4.01 to 7.59 +/- 5.30 min; *P < 0.001, **P < 0.01, respectively). These results suggest that MAG-3 scintigraphy is a highly sensitive method in the early detection of cisplatin-induced nephrotoxicity. Serum cystatin C doesn't seem to play a role in the early detection of cisplatin-induced nephrotoxicity. As a result, MAG-3 scintigraphy may be used in selected patients who have a predisposition for renal toxicity.