Multivariate analysis of risk factors for cisplatin‐induced nephrotoxicity in gynecological cancer

Abstract

Aim: Risk factors for cisplatin-induced nephrotoxicity (CIN) vary by population. This study aimed to assess risk factors for CIN in patients with gynecological cancer. Methods: Patients who underwent cisplatin-based chemotherapy for gynecological cancer between January 2009 and December 2015 at Aichi Medical University School of Medicine were included in this study. CIN was defined according to the 'risk, injury, failure, loss, and end-stage kidney disease' (RIFLE) criteria and classified as either risk (Class R) or injury (Class I). Analyses were performed using univariate and multivariate logistic regression models. Results: Among 112 patients enrolled, 30 had CIN. Multivariate analysis revealed that hydration with magnesium (odds ratio [OR], 0.223), history of cisplatin use (OR, 4.420), and hypoalbuminemia (OR, 4.170) were risk factors for Class R, and that frequency of cisplatin administration (OR, 5.620) and hydration with magnesium (OR, 0.216) were risk factors for Class I. Conclusion: This study confirmed that hydration without magnesium, history of cisplatin use, frequency of cisplatin administration, and hypoalbuminemia are significant risk factors for CIN.

Insonation of Systemically Delivered Cisplatin-Loaded Microbubbles Significantly Attenuates Nephrotoxicity of Chemotherapy in Experimental Models of Head and Neck Cancer

“…Cancer patients are known to have relatively decreased plasma albumin levels when compared to healthy subjects. Patients with lower albumin levels are prone to have a higher unbound fraction of plasma CDDP and a reduced CDDP half-life [ 38 , 39 ]. Hypoalbuminemia may also affect the peritubular oncotic pressure and in turn affect Pt excretion [ 40 ], thereby putting these patients at greater risk of nephrotoxicity.…”

Comparison of Myelotoxicity and Nephrotoxicity Between Daily Low-Dose Cisplatin With Concurrent Radiation and Cyclic High-Dose Cisplatin in Non-Small Cell Lung Cancer Patients

“…Additional covariates for myelotoxicity were as follows: number of comorbidities, and any of the following baseline disease states as defined by blood cell counts; anemia by hemoglobin, leukopenia by leukocytes, neutropenia by neutrophils, thrombocytopenia by platelets ( Moreau et al., 2009 ; Hardy et al., 2010 ; Castelan-Martinez et al., 2016 ; Nishikawa et al., 2017 ). Number of comorbidities, baseline serum creatinine, albumin, magnesium, phosphate, and potassium were included for Cr-electrolyte nephrotoxicity while baseline albumin and eGFR were covariates for chronic nephrotoxicity ( Kidera et al., 2014 ; Yamamoto et al., 2017 ). Unlike Cr-electrolyte nephrotoxicity, SCr-AKI was not corrected for baseline electrolyte values while electrolyte abnormalities weren’t corrected for baseline serum creatinine.…”

Comparison of Equations To Estimate Glomerular Filtration Rate and Their Impact on Frequency of Cisplatin-associated Acute Kidney Injury

“…However, the relative proportions of C-AKI across various equations were not profoundly different for two possible reasons: First, baseline kidney function by eGFR or eCrCl alone has not been consistently shown to predict C-AKI. [36][37][38][39][40][41] Second, our cohort, despite being very large and inclusive, did not have many patients with very low eGFR (ie, patients who would presumably be at highest risk of C-AKI). The mean eGFRCKD-EPI in the <60 ml/min/1.73 m 2 group was 51.3 ml/min/1.73 m 2 .…”