Preventive effect of 20 mEq and 8 mEq magnesium supplementation on cisplatin-induced nephrotoxicity: a propensity score–matched analysis

Abstract

The protective effect of magnesium (Mg) supplementation against cisplatin (CDDP)-induced nephrotoxicity has been widely described; however, the optimal dose of Mg supplementation is unclear. The aim of this study was to investigate whether 20 mEq of Mg supplementation is more effective than 8 mEq Mg in preventing CDDP-induced nephrotoxicity, as well as the associated risk factors, in cancer patients treated with CDDP-based chemotherapy. MethodsPooled data of 272 patients receiving 20 mEq or 8mEq Mg supplementation to CDDP-based chemotherapy from a multicenter, retrospective, observational study were compared using propensity score matching.Separate multivariate logistic regression analyses were used to identify the risk factors for renal failure induced by each treatment dose. ResultsThere was no signi cant difference in the incidence of CDDP-induced nephrotoxicity between the 8 mEq and 20 mEq groups (18.4% vs. 20.6%, P = 0.760). There was also no signi cant difference in the severity of nephrotoxicity, elevated serum creatinine levels, and decreased estimated creatinine clearance levels between the two groups. Cardiac disease and albumin levels were identi ed as independent risk factors for CDDPinduced nephrotoxicity. ConclusionWe did not nd an advantage of 20 mEq over 8 mEq Mg supplementation in terms of a preventive effect against CDDP-induced nephrotoxicity. The optimal dose of Mg supplementation for the prevention of CDDPinduced nephrotoxicity remains unknown, and further studies are warranted.

Risk factor analysis for cisplatin-induced nephrotoxicity with the short hydration method in diabetic patients

“…Univariate and multivariate logistic regression analyses were performed using the following possible covariates: sex, age, ECOG-PS, staging, body surface area (BSA), anemia, hypoalbuminemia, liver dysfunction (grade 1 or higher aspartate aminotransferase, alanine aminotransferase, total bilirubin elevation), renal dysfunction (creatinine clearance calculated by Cockroft-Gault formula of < 60 mL/min), concomitant hypertension, and co-administration of PPIs and NSAIDs as baseline patient factors; administration of DPP-4 inhibitors or GLP-1 analogs, metformin, sulfonylurea agents or glinides, insulin, sodium-glucose cotransporter 2 inhibitors, and α-glucosidase inhibitors as DM medication influence; and CDDP dosage, treatment courses, dose reduction during the treatment, radiation combination, and development of grade ≥ 2 nausea, vomiting, and anorexia for treatment-related factors according to previous reports 3,4,9,11,[16][17][18][30][31][32][33][34][35][36][37][38] . Previously reported variables that demonstrated potential associations with CIN development in univariate logistic regression analysis (P < 0.20) were considered when building the multivariable model.…”

Cisplatin in Liver Cancer Therapy

“…Magnesium supplementation with hydration inhibits the nephrotoxicity of cisplatin [ 103 , 104 , 105 , 106 ]. Magnesium may be involved in transporters for cisplatin intracellular influx or excretion, and magnesium deficiency increases intracellular accumulation [ 107 , 108 , 109 ].…”

Comparison of Preventive Effects of Combined Furosemide and Mannitol versus Single Diuretics, Furosemide or Mannitol, on Cisplatin-Induced Nephrotoxicity

“…Additionally, hypomagnesemia induces the saturation of active transport mechanisms in renal tubular cells, leading to excessive CDDP levels in renal tubular cells and subsequent cell necrosis. Therefore, magnesium (Mg) supplementation has been used to prevent nephrotoxicity, and its preventive effects have been described in several studies [7][8][9][10][11] .…”