Nephrotoxicity of cisplatin combination chemotherapy in thoracic malignancy patients with CKD risk factors

BMC Cancer

Research Article

Hirohisa Yoshizawa¹  Satoshi Watanabe¹  Junta Tanaka²  Ko Sato³  Masaaki Okajima³  Satoshi Shoji³  Daisuke Ishikawa³  Toshiyuki Koya³  Takuro Sakagami³  Koichiro Nozaki³  Aya Ohtsubo³  Rie Kondo³  Satoru Miura³  Tomohiro Tanaka³  Ichiei Narita³  Hiroshi Kagamu³ 

[1] Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan;Department of Health Promotion Medicine, Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan;Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan;

关键词: Cisplatin;    Nephrotoxicity;    Chronic kidney disease;    Acute kidney injury;   

DOI  :  10.1186/s12885-016-2271-8

 received in 2015-01-21, accepted in 2016-03-10,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundNephrotoxicity is the major side effect that limits the dose of cisplatin that can be safely administered, and it is a clinical problem in cancer patients who received cisplatin combination chemotherapy. Recent evidence has demonstrated that patients with chronic kidney disease (CKD) have an increased risk of developing acute kidney injury (AKI). The present study was conducted to evaluate the prevalence of CKD risk factors in patients who received cisplatin and to assess the correlation between CKD risk factors and cisplatin-induced AKI.MethodsWe retrospectively analyzed 84 patients treated with cisplatin combination chemotherapy for thoracic malignancies. AKI was defined as a decrease in the estimated glomerular filtration rate (eGFR) > 25 % from base line, an increase in the serum creatinine (sCre) level of > 0.3 mg/dl or ≥ 1.5 times the baseline level.ResultsEighty of the 84 patients (95.2 %) had at least one risk factor for CKD. All enrolled patients received cisplatin with hydration, magnesium supplementation and mannitol. Cisplatin-induced AKI was observed in 18 patients (21.4 %). Univariate analysis revealed that cardiac disease and use of non-steroidal anti-inflammatory drugs (NSAIDs) were associated with cisplatin-induced nephrotoxicity (odds ratios [OR] 6 and 3.56, 95 % confidence intervals [CI] 1.21–29.87 and 1.11–11.39, p = 0.04 and p = 0.04, respectively). Multivariate analysis revealed that cisplatin nephrotoxicity occurred significantly more often in patients with both risk factors (OR 13.64, 95 % CI 1.11–326.83, p = 0.04). Patients with more risk factors for CKD tended to have a greater risk of developing cisplatin-induced AKI.ConclusionsWe should consider avoiding administration of cisplatin to patients with CKD risk factors, particularly cardiac disease and NSAID use.

【 授权许可】

CC BY   
© Sato et al. 2016