Risk Factors for Cisplatin-Induced Nephrotoxicity: A Multicenter Retrospective Study.

ABSTRACT

INTRODUCTION: Cisplatin (CDDP)-induced nephrotoxicity is a concern in CDDP-based chemotherapy. The goal of this multicenter retrospective study was to identify potential risk factors for CDDP nephrotoxicity. METHODS: Clinical data were reviewed for 762 patients who underwent chemotherapy including CDDP ≥60 mg/m2 per day from Spring 2014 to September 2016. CDDP nephrotoxicity was defined according to the National Cancer Institute Common Terminology Criteria for Adverse Events for acute kidney injury. Univariate and multivariate logistic regression analyses were performed to identify risk factors for CDDP nephrotoxicity. RESULTS: CDDP nephrotoxicity was observed in 165 patients (21.7%). Multivariate analysis showed a significantly higher rate of CDDP nephrotoxicity in patients with cardiac disease (odds ratio [OR] 2.05, 95% confidence interval [CI] 1.07-3.93, p = 0.03), hypertension (OR 1.57, 95% CI 1.06-2.32, p = 0.02), and high-dose CDDP therapy (OR 2.15, 95% CI 1.50-3.07, p < 0.01). Magnesium (Mg) supplementation (OR 0.65, 95% CI 0.45-0.93, p = 0.02) and diuretic use (OR 0.22, 95% CI 0.08-0.63, p < 0.01) were also independent risk factors for CDDP nephrotoxicity. CONCLUSIONS: Our results suggest that high-dose CDDP and comorbidities of cardiac disease and hypertension are independent risk factors for CDDP nephrotoxicity. Therefore, close monitoring of serum creatinine values during CDDP treatment is recommended for patients with these risk factors. In addition, Mg supplementation and administration of diuretics might be effective for prevention of CDDP nephrotoxicity.