The use of antihypertensive medications in cancer patients on chemo immunotherapy: Protection or not?

Abstract

e19238 Background: Antihypertensive medications is a widely used in the cancer patients due to comorbid hypertension. The following analysis was devoted to find if any particular group can provide nephroprotective effect for patient that is receiving chemo immunotherapy. Methods: A retrospective cohort of the 95 patients, who received chemo immunotherapy in the infusion center of Mercy Fitzgerald Hospital in 2018-2020 were analyzed. We divided patient in 4 groups. Those who were receiving beta-blockers - group 1, angiotensin-converting enzyme/angiotensin receptor blockers – group 2, dihydropyridine calcium channel blocker – group 3, non-dihydropyridine calcium channel blocker – group 4. KDIGO criteria were used to identify patients with Acute Kidney Injury (AKI). Chi-square test was used to estimate if there is association between using specific group of anti-hypertensives medications and AKI. Results: 12 out of 95 patients in the study developed AKI. In group 1 5 had AKI and 23 not, p = .032. Group 2 included 3 patient who developed AKI and 22 who did not, p = 0.91. Group 3 group had 6 patients with AKI and 10 without, p = 0.001. Group 4 had 10 patients and none of them had AKI, p = 0.16. Conclusions: In our study we found that patient who were using the dihydropyridine calcium channel blocker (amlodipine) had a higher incidence of the AKI then patients, who were using other groups of the anti-hypertensive medications. Large prospective studies may be necessary to confirm that use of amlodipine in patients who undergo chemo immunotherapy is associated with higher incidence of the AKI and should be avoided in the treatment of this patients.