Cisplatin treatment in adult cancer survivors was associated with a 31.5% incidence of AKI, with patients >66 years having a higher risk compared to those <25 years (OR 2.96; 95% CI 1.4-6.1).
Cohort (n=821)
Does cisplatin treatment cause long-term renal impairment in adult cancer survivors?
Cisplatin treatment causes small but permanent declines in eGFR and a 31.5% incidence of AKI, but progression to ESRD requiring hemodialysis is extremely rare among long-term survivors.
Odds Ratio: 2.96 (95% CI 1.4–6.1)
BACKGROUND AND OBJECTIVES: Nephrotoxicity remains the dose-limiting side effect of cisplatin, an effective chemotherapeutic agent with applications across diverse tumor types. This study presents data on renal outcomes across multiple tumor types in 821 adults. We report on incidence of AKI, initial and long-term changes in eGFR after cisplatin, and relationships between cumulative dose, initial eGFR, age, sex, and long-term renal function. DESIGN, SETTING, PARTICIPANTS, ANOVAs or t tests were used to evaluate continuous or categorical variables. Changes in eGFR over time were evaluated in a growth curve model. RESULTS: Mean follow-up was 6 years (25th and 75th percentiles, 4 and 9 years). AKI occurred in 31.5% of patients, with a median initial decline in eGFR of 10 ml/min per 1.73 m(2) (25th and 75th percentiles, -41.5 and -23.3 ml/min per 1.73 m(2)). At any time point after the first cycle of cisplatin, 26-44 years old (95% confidence interval 95% CI, 0.60 to 2.4), 1.54 for >45-65 years old (95% CI, 0.78 to 3), and 2.96 for >66 years old (95% CI, 1.4 to 6.1). The lowest dose categories of cisplatin (≤100 and 101-250 mg/m(2)) are associated with increases in eGFR (P=0.06 and P=0.02, respectively) compared with the highest dose category (>701 mg/m(2)). CONCLUSIONS: This is the largest study of adult patients with cancer who received cisplatin for treatment across multiple tumor types. Most patients experience small but permanent declines in eGFR, but none progressed to ESRD requiring hemodialysis.
Latcha et al. (2016) conducted a cohort in Cancer (n=821). Cisplatin vs. Age <25 years (for AKI) and dose >701 mg/m(2) (for eGFR) was evaluated on Incidence of AKI (OR 2.96, 95% CI 1.4-6.1). Cisplatin treatment in adult cancer survivors was associated with a 31.5% incidence of AKI, with patients >66 years having a higher risk compared to those <25 years (OR 2.96; 95% CI 1.4-6.1).