Impact of cisplatin-induced acute kidney injury on long-term renal function in patients with solid tumors

• Published in: Clinical and experimental nephrology Vol. 27; no. 6; pp. 506 - 518
• Main Authors: Hino, Amiko, Muto, Satoru, Shimada, Yosuke, Hori, Satoshi, Isotani, Shuji, Nagata, Masayoshi, Horie, Shigeo
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.06.2023
• Subjects: Acute Kidney Injury - chemically induced; Acute Kidney Injury - diagnosis; Acute Kidney Injury - epidemiology; Adult; Antineoplastic Agents; Cisplatin - adverse effects; Cohort Studies; Glomerular Filtration Rate; Humans; Kidney; Liver Neoplasms; Medicine; Medicine & Public Health; Nephrology; Original Article; Retrospective Studies; Urology; Solid tumor; Chronic kidney disease; Nephrotoxicity; Acute kidney injury; Cisplatin
• ISSN: 1342-1751; 1437-7799
• DOI: 10.1007/s10157-023-02324-2

Background The reality of cisplatin-induced acute kidney injury (CIA) and its effects on long-term renal function remain unclear. The aim of this study was to investigate the incidence and risk factors for CIA development, and if CIA is a useful predictor of long-term renal dysfunction after cisplatin treatment. Methods This was a retrospective, single-center, observational, longitudinal follow-up, large cohort study in adult patients with solid tumors treated with cisplatin-based systematic chemotherapy. Electronic medical records were used for all demographic and medical data. AKI was defined by Kidney Disease Improving Global Outcomes (KDIGO) criteria. We assessed long-term renal dysfunction using %ΔeGFR/Y; (the last eGFR value during follow-up)—(the baseline eGFR)/(the baseline eGFR)/year of follow-up × 100. Results A total of 2191 patients received 8,482 cycles of cisplatin. CIA was observed 359 times (4.2%). Significant risk factors for developing CIA, using multiple linear regression analysis, included: cisplatin administration immediately before the onset of CIA ( p  < 0.01), liver cancer ( p  = 0.02), colon cancer ( p  = 0.04), hypertension ( p  = 0.03), high estimated glomerular filtration rate (eGFR) ( p  < 0.01), and high C-reactive protein (CRP) ( p  = 0.04). Significant risk factors for %ΔeGFR/Y, using multivariate linear regression analysis, included: esophageal cancer ( p  < 0.01), lung cancer ( p  < 0.01), pharyngeal cancer ( p  = 0.02), Head and neck cancer ( p  < 0.01), liver cancer ( p  = 0.02), potassium ( p  < 0.01), and CIA ( p  < 0.01). Conclusions To our knowledge, this is the first study to show that CIA is a significant predictive risk factor for long-term renal dysfunction after cisplatin administration. Effective strategies are needed to prevent CIA in cancer patients.