Key result
A short hydration scheme was associated with a significantly smaller decline in renal function compared to a long hydration scheme in patients receiving cisplatin (P=.000).
Why the study?
Nephrotoxicity is a common side effect of cisplatin that hydration may reduce, but whether short versus long hydration schemes differ in renal function decline was unknown.
Does a short hydration scheme reduce decline in renal function compared to a long hydration scheme in patients receiving cisplatin for non-small-cell lung cancer?
Cohort
Yes
Does a short hydration scheme reduce decline in renal function compared to a long hydration scheme in patients receiving cisplatin for non-small-cell lung cancer?
p-value: p=.000
A short hydration scheme for cisplatin therapy in non-small-cell lung cancer is associated with less renal function decline and fewer premature treatment discontinuations due to nephrotoxicity compared to a long hydration scheme.
May support shorter hydration to limit cisplatin nephrotoxicity; leaves open confirmation in randomized NSCLC trials.
WHAT IS KNOWN AND OBJECTIVE: Nephrotoxicity is a frequently occurring side effect of cisplatin, which may be reduced by applying ample hydration. The aim of this study was to determine whether there is a difference in decline in renal function due to cisplatin between a short hydration (SH) and long hydration scheme (LH). METHODS: A retrospective, observational, cohort study was conducted in two hospitals. Patients in one hospital received an SH scheme (SH group), whereas patients in the other hospital received an LH scheme (LH group). Other aspects of treatment and hydration were comparable between both patient groups. Consecutive patients (≥18 years) treated for non-small-cell lung cancer with cisplatin-pemetrexed with ≥1 cisplatin dose were included. Patients were excluded when serum creatinine at baseline was <40 μmol/L. Primary outcome was the difference in estimated glomerular filtration rate (eGFR) between baseline and after the last cisplatin cycle for the SH and LH patients, regardless of the number of administered cisplatin courses. RESULTS: (interquartile range) for the SH and LH group, respectively (P = .000). Less patients completed the four cycles in the LH group (16%) compared to the SH group (64%), mainly because more LH patients were switched to another treatment and due to nephrotoxicity. However, the difference in eGFR remained statistically significant (P = .027). WHAT IS NEW AND CONCLUSION: In this retrospective study, the SH scheme resulted in less decrease in renal function compared with the LH scheme, with a significant and clinically relevant difference. Additionally, more LH patients had to stop this effective treatment prematurely due to nephrotoxicity. Therefore, a short hydration scheme provides adequate and safe hydration, with a lower risk of nephrotoxic side effects and therefore better outcomes for patients and a reduction of healthcare costs.
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Niggebrugge‐Mentink et al. (2020) conducted a cohort in Non-small-cell lung cancer. Short hydration scheme vs. Long hydration scheme was evaluated on Difference in estimated glomerular filtration rate (eGFR) between baseline and after the last cisplatin cycle (p=.000). A short hydration scheme was associated with a significantly smaller decline in renal function compared to a long hydration scheme in patients receiving cisplatin (P=.000).
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