論文

国際誌
2016年3月15日

Nephrotoxicity of cisplatin combination chemotherapy in thoracic malignancy patients with CKD risk factors.

BMC cancer
  • Ko Sato
  • ,
  • Satoshi Watanabe
  • ,
  • Aya Ohtsubo
  • ,
  • Satoshi Shoji
  • ,
  • Daisuke Ishikawa
  • ,
  • Tomohiro Tanaka
  • ,
  • Koichiro Nozaki
  • ,
  • Rie Kondo
  • ,
  • Masaaki Okajima
  • ,
  • Satoru Miura
  • ,
  • Junta Tanaka
  • ,
  • Takuro Sakagami
  • ,
  • Toshiyuki Koya
  • ,
  • Hiroshi Kagamu
  • ,
  • Hirohisa Yoshizawa
  • ,
  • Ichiei Narita

16
開始ページ
222
終了ページ
222
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s12885-016-2271-8

BACKGROUND: Nephrotoxicity is the major side effect that limits the dose of cisplatin that can be safely administered, and it is a clinical problem in cancer patients who received cisplatin combination chemotherapy. Recent evidence has demonstrated that patients with chronic kidney disease (CKD) have an increased risk of developing acute kidney injury (AKI). The present study was conducted to evaluate the prevalence of CKD risk factors in patients who received cisplatin and to assess the correlation between CKD risk factors and cisplatin-induced AKI. METHODS: We retrospectively analyzed 84 patients treated with cisplatin combination chemotherapy for thoracic malignancies. AKI was defined as a decrease in the estimated glomerular filtration rate (eGFR) > 25% from base line, an increase in the serum creatinine (sCre) level of > 0.3 mg/dl or ≥ 1.5 times the baseline level. RESULTS: Eighty of the 84 patients (95.2%) had at least one risk factor for CKD. All enrolled patients received cisplatin with hydration, magnesium supplementation and mannitol. Cisplatin-induced AKI was observed in 18 patients (21.4%). Univariate analysis revealed that cardiac disease and use of non-steroidal anti-inflammatory drugs (NSAIDs) were associated with cisplatin-induced nephrotoxicity (odds ratios [OR] 6 and 3.56, 95% confidence intervals [CI] 1.21-29.87 and 1.11-11.39, p = 0.04 and p = 0.04, respectively). Multivariate analysis revealed that cisplatin nephrotoxicity occurred significantly more often in patients with both risk factors (OR 13.64, 95% CI 1.11-326.83, p = 0.04). Patients with more risk factors for CKD tended to have a greater risk of developing cisplatin-induced AKI. CONCLUSIONS: We should consider avoiding administration of cisplatin to patients with CKD risk factors, particularly cardiac disease and NSAID use.

リンク情報
DOI
https://doi.org/10.1186/s12885-016-2271-8
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/26979596
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793503
ID情報
  • DOI : 10.1186/s12885-016-2271-8
  • PubMed ID : 26979596
  • PubMed Central 記事ID : PMC4793503

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