Abstract
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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2271-8) contains supplementary material, which is available to authorized users.
Highlights
Nephrotoxicity 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
Risk factors To identify the risk factors potentially associated with the occurrence of a cisplatin-induced nephrotoxicity, we examined the relationship between acute kidney injury (AKI) incidence and the following 17 chronic kidney disease (CKD) risk factors: old age (≥70 years old), proteinuria, hematuria, dyslipidemia, diabetes mellitus, hypertension, hyperuricemia, obesity, smoking, non-steroidal anti-inflammatory drugs (NSAIDs) use, cerebrovascular disease, cardiac disease, autoimmune disease, infectious disease, urinary-tract stone and a history of acute renal failure [13]
Patient characteristics A total of 84 patients who were treated with cisplatin combination chemotherapy for thoracic malignancies were included in this study
Summary
Nephrotoxicity 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. Patients with risk factors for CKD may have a higher incidence of cisplatin-induced nephrotoxicity. The aims of this study were to evaluate the prevalence of CKD risk factors in thoracic malignancy patients who received cisplatin and to elucidate the correlation between nephrotoxicity due to cisplatin-based chemotherapy in patients with CKD risk factors
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