Abstract
BackgroundCisplatin is an important drug in the treatment of various Cancers. However, this drug causes nephrotoxicity that is linked to electrolyte derangement. The aim of this study was to evaluate the effect of electrolyte supplementation in reducing kidney injury in patients receiving cisplatin-based regimen.MethodsThis was non-randomized interventional study conducted at Ocean Road Cancer Institute (ORCI) among patients with confirmed solid tumors. Patients who received cisplatin-based chemotherapy at a dose of ≥50 mg with intravenous normal saline supplemented with Magnesium, Calcium and Potassium (triple electrolyte supplementation) were compared with those who received cisplatin-based chemotherapy with normal saline alone. The patients were followed up for 4 weeks and serum creatinine was measured at every visit. Nephrotoxicity was defined as serum creatinine elevation > 1.5 times that at baseline.ResultsA total of 99 patients were recruited, whereby 49 patients (49.5%) received electrolyte supplementation (treatment group) and 50 patients (51.5%) did not receive electrolyte supplementation (control group). The incidence risk of nephrotoxicity was 20.41% (n = 10) in the treatment group and 54% (n = 27) in the control group. Patients in the control group were 2.6 times more likely to experience nephrotoxicity as compared to treatment group [Relative Risks (RR); 2.6, 95%CI; 1.5–4.9, P < 0.0001]. The most common malignancy was cervical cancer, n = 43 (87.8%) in treatment group and n = 45 (90.0%) in the control group (P = 0.590). The Kaplan-Meier analysis and the log-rank test revealed that electrolytes supplementation was associated with extended survival with less nephrotoxicity incidences [P = 0.0004; Hazard ratio (HR) 0.3149; 95% CI 0.165 to 0.6011].ConclusionsElectrolytes supplementation decreases the risk of nephrotoxicity after chemotherapy with cisplatin. A randomized controlled trial with a larger sample size is recommended to evaluate the robustness of these findings.
Highlights
Cancer is currently becoming a health problem concern in several less developed and economically transitioning countries
We report the protective effect of triple electrolyte supplementation with potassium, magnesium, and calcium among patients with solid tumors who were undergoing cisplatinbased chemotherapy at ocean Road Cancer Institute in Dar Es Salaam, Tanzania
Nephrotoxicity was defined as serum creatinine elevation > 1.5 times that at baseline and was always measured on the 7th day of each clinic attendance just after administration of the cisplatin dose
Summary
Cancer is currently becoming a health problem concern in several less developed and economically transitioning countries. While the incidence and mortality rates for most cancers in the United States and many other western countries are decreasing, the trend in several less developed and economically transitioning countries is the opposite because of adoption of unhealthy western lifestyles such as smoking, physical inactivity, and consumption of calorie-dense food [1, 2]. To contain the trends of increased morbidity and mortality in these countries, there is an urgent need for instituting preventive strategies such as lifestyle changes and educating the population to timely turn to health facilities for early detection, diagnosis, and treatment. Cisplatin is an important drug in the treatment of various Cancers This drug causes nephrotoxicity that is linked to electrolyte derangement. The aim of this study was to evaluate the effect of electrolyte supplementation in reducing kidney injury in patients receiving cisplatin-based regimen
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