Persistent nephrotoxicity during 10-year follow-up after cisplatin or carboplatin treatment in childhood: Relevance of age and dose as risk factors

Skinner, Roderick; Parry, Annie; Price, L.; Cole, Michael; Craft, Alan; Pearson, Andrew D.J.

doi:10.1016/j.ejca.2009.06.032

Cited by 104 publications

(137 citation statements)

References 26 publications

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“…After a median of 12 years since cancer diagnosis and at a median age of 18 years, almost 30% of all survivors had impaired GFR or tubular function or an elevated BP. Only a few studies have investigated long-term renal effects in survivors of childhood cancer, focusing on the effects of ifosfamide and platinum derivates (5,8,9). However, studies of long-term renal adverse effects and hypertension that have evaluated other types of chemotherapy, radiation therapy, and surgery are lacking.…”

Section: Discussionmentioning

confidence: 99%

“…Tubular toxicity seemed to resolve during followup, but after 10 years GFR was still decreased in 13% of the survivors (8). Platinum nephrotoxicity was persistent during follow-up, but late deterioration of glomerular and tubular function did not occur (9). The studies by both Skinner et al (8,9) and Oberlin et al (5) did not include patients treated with both ifosfamide and platinum derivates, although this combination is used in the treatment of certain tumors.…”

Section: Introductionmentioning

confidence: 99%

“…Platinum nephrotoxicity was persistent during follow-up, but late deterioration of glomerular and tubular function did not occur (9). The studies by both Skinner et al (8,9) and Oberlin et al (5) did not include patients treated with both ifosfamide and platinum derivates, although this combination is used in the treatment of certain tumors. Besides these agents, high-dose methotrexate and cyclophosphamide are known for their acute nephrotoxicity, but evidence regarding their long-term effects is lacking (11).…”

Section: Introductionmentioning

confidence: 99%

“…Few studies have evaluated long-term risk and risk factors for renal toxicity, and these studies were performed only in selected groups of survivors with a maximum of 10 years' follow-up (5,8,9). A mild reduction in GFR and proximal tubular damage were the most common toxicities 10 years after ifosfamide use (5).…”

Section: Introductionmentioning

confidence: 99%

“…Chemotherapeutic agents with well documented early nephrotoxicity are ifosfamide, cisplatin, and carboplatin (5)(6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

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Renal Dysfunction and Elevated Blood Pressure in Long-Term Childhood Cancer Survivors

Knijnenburg¹,

Jaspers²,

Pal³

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Little is known about renal function and blood pressure (BP) in long-term childhood cancer survivors. This cross-sectional study evaluated prevalence of these outcomes and associated risk factors in long-term childhood cancer survivors at their first visit to a specialized outpatient clinic.Design, Setting, Participants, & Measurements Estimated GFR; percentages of patients with albuminuria, hypomagnesemia, and hypophosphatemia; and BP were assessed in 1442 survivors $5 years after diagnosis. Multivariable logistic regression analyses were used to estimate effect of chemotherapy, nephrectomy, and radiation therapy on the different outcomes.Results At a median age of 19.3 years (interquartile range, 15.6-24.5 years), 28.1% of all survivors had at least one renal adverse effect or elevated BP. The median time since cancer diagnosis was 12.1 years (interquartile range, 7.8-17.5 years). High BP and albuminuria were most prevalent, at 14.8% and 14.5%, respectively. Sixty-two survivors (4.5%) had an estimated GFR ,90 ml/min per 1.73 m 2 . Survivors who had undergone nephrectomy had the highest risk for diminished renal function (odds ratio, 8.6; 95% confidence interval [CI], 3.4-21.4). Combined radiation therapy and nephrectomy increased the odds of having elevated BP (odds ratio, 4.92; 95% CI, 2.63-9.19), as did male sex, higher body mass index, and longer time since cancer treatment.Conclusion Almost 30% of survivors had renal adverse effects or high BP. Therefore, monitoring of renal function in high-risk groups and BP in all survivors may help clinicians detect health problems at an early stage and initiate timely therapy to prevent additional damage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Chemotherapeutic agents with well documented early nephrotoxicity are ifosfamide, cisplatin, and carboplatin (5)(6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Renal Dysfunction and Elevated Blood Pressure in Long-Term Childhood Cancer Survivors

Knijnenburg¹,

Jaspers²,

Pal³

et al. 2012

Clinical Journal of the American Society of Nephrology

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Cisplatin-Associated Nephrotoxic Effects in Children

Motwani

Curhan

2020

JAMA Netw Open

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Cisplatin has been an important component of chemotherapy for cure and control of several pediatric and adult malignant tumors. Nephrotoxic effects of cisplatin are a limitation of cisplatinbased chemotherapy and are often prohibitive of further treatment with cisplatin, when they occur.However, this adverse effect is not uniformly manifested among all patients who receive cisplatinbased chemotherapy. 1 During the past few decades, investigators have attempted to identify risk factors that predispose certain patients to nephrotoxic effects of cisplatin while sparing others.Interindividual variability in kidney injury associated with cisplatin is greater than that explained by pharmacokinetic differences among patients. 2 What, if anything, can practitioners at the point of care do to ameliorate this risk of cisplatin-associated acute kidney injury (AKI) and subsequent chronic kidney disease while preserving the anticancer benefit? Common themes have emerged from the collective body of published work. Risk factors, such as age, cisplatin dose, concomitant chemotherapy, and administration of nephrotoxins, have been identified. However, these findings largely stem from retrospective studies 3 with varying study designs, patient selection algorithms, sample sizes, length of follow-up, and overall rigor. In addition, few studies thus far have homed in on risk factors in the pediatric population. McMahon et al 4 report on a prospectively evaluated, multicenter, pediatric cohort of early and late risk factors for nephrotoxic effects of cisplatin. The prospective study design, multicenter recruitment, rigorous methods, and robust statistical analysis are strengths of their study.

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Epidemiologic Characteristics of Acute Kidney Injury During Cisplatin Infusions in Children Treated for Cancer

et al. 2020

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IMPORTANCE Few multicenter pediatric studies have comprehensively described the epidemiologic characteristics of cisplatin-associated acute kidney injury using standardized definitions. OBJECTIVE To examine the rate of and risk factors associated with acute kidney injury among children receiving cisplatin infusions. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study examined children (aged <18 years) recruited from May 23, 2013, to March 31, 2017, at 12 Canadian pediatric academic health centers who were receiving 1 or more cisplatin infusion. Children whose estimated or measured glomerular filtration rate (GFR) was less than 30 mL/min/1.73 m 2 or who had received a kidney transplant were excluded. Data analysis was performed from January 3, 2018, to September 20, 2019. EXPOSURES Cisplatin infusions. MAIN OUTCOMES AND MEASURES The primary outcome was acute kidney injury during cisplatin infusion, defined using a Kidney Disease: Improving Global Outcomes serum creatinine criteriabased definition (stage 1 or higher). The secondary outcome was acute kidney injury defined by electrolyte criteria from the National Cancer Institute Common Terminology Criteria for Adverse Events (grade 1 or higher). Assessments occurred at early (first or second cycle) and late (last or second to last cycle) cisplatin infusions. RESULTS A total of 159 children (mean [SD] age at early cisplatin infusion, 7.2 [5.3] years; 80 [50%] male) participated. The most common diagnoses were central nervous system tumors (58 [36%]), neuroblastoma (43 [27%]), and osteosarcoma (33 [21%]). Acute kidney injury (by serum creatinine level increase) occurred in 48 of 159 patients (30%) at early cisplatin infusions and 23 of 143 patients (16%) at late cisplatin infusions. Acute kidney injury (by electrolyte abnormalities) occurred in 106 of 159 patients (67%) at early cisplatin infusion and 100 of 143 patients (70%) at late cisplatin infusions. Neuroblastoma diagnosis and higher precisplatin GFR were independently associated with acute kidney injury (serum creatinine level increase) at early cisplatin infusions (adjusted odds ratio [aOR] for neuroblastoma vs other, 3.25; 95% CI, 1.18-8.95; aOR for GFR, 1.01; 95% CI, 1.00-1.03) and late cisplatin infusions (aOR for neuroblastoma vs other, 6.85; 95% CI, 1.23-38.0; aOR for GFR, 1.01; 95% CI, 1.00-1.03). Higher cisplatin infusion dose was also independently associated with acute kidney injury (serum creatinine level increase) at later cisplatin infusions (aOR, 1.05; 95% CI, 1.01-1.10).

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Persistent nephrotoxicity during 10-year follow-up after cisplatin or carboplatin treatment in childhood: Relevance of age and dose as risk factors

Cited by 104 publications

References 26 publications

Renal Dysfunction and Elevated Blood Pressure in Long-Term Childhood Cancer Survivors

Renal Dysfunction and Elevated Blood Pressure in Long-Term Childhood Cancer Survivors

Cisplatin-Associated Nephrotoxic Effects in Children

Epidemiologic Characteristics of Acute Kidney Injury During Cisplatin Infusions in Children Treated for Cancer

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