<b><i>Introduction:</i></b> 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. <b><i>Methods:</i></b> Clinical data were reviewed for 762 patients who underwent chemotherapy including CDDP ≥60 mg/m<sup>2</sup> 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. <b><i>Results:</i></b> 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, <i>p</i> = 0.03), hypertension (OR: 1.57, 95% CI: 1.06–2.32, <i>p</i> = 0.02), and high-dose CDDP therapy (OR: 2.15, 95% CI: 1.50–3.07, <i>p</i> < 0.01). Magnesium (Mg) supplementation (OR: 0.65, 95% CI: 0.45–0.93, <i>p</i> = 0.02) and diuretic use (OR: 0.22, 95% CI: 0.08–0.63, <i>p</i> < 0.01) were also independent risk factors for CDDP nephrotoxicity. <b><i>Conclusions:</i></b> 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.
The protective effect of magnesium (Mg) supplementation against cisplatin (CDDP)-induced nephrotoxicity has been widely described; however, the optimal dose of Mg supplementation is unclear. The aim of this study was to investigate whether 20 mEq of Mg supplementation is more effective than 8 mEq Mg in preventing CDDP-induced nephrotoxicity, as well as the associated risk factors, in cancer patients treated with CDDP-based chemotherapy. MethodsPooled data of 272 patients receiving 20 mEq or 8mEq Mg supplementation to CDDP-based chemotherapy from a multicenter, retrospective, observational study were compared using propensity score matching.Separate multivariate logistic regression analyses were used to identify the risk factors for renal failure induced by each treatment dose. ResultsThere was no signi cant difference in the incidence of CDDP-induced nephrotoxicity between the 8 mEq and 20 mEq groups (18.4% vs. 20.6%, P = 0.760). There was also no signi cant difference in the severity of nephrotoxicity, elevated serum creatinine levels, and decreased estimated creatinine clearance levels between the two groups. Cardiac disease and albumin levels were identi ed as independent risk factors for CDDPinduced nephrotoxicity. ConclusionWe did not nd an advantage of 20 mEq over 8 mEq Mg supplementation in terms of a preventive effect against CDDP-induced nephrotoxicity. The optimal dose of Mg supplementation for the prevention of CDDPinduced nephrotoxicity remains unknown, and further studies are warranted.
Purpose The protective effect of magnesium (Mg) supplementation against cisplatin (CDDP)-induced nephrotoxicity has been widely described; however, the optimal dose of Mg supplementation is unclear. The aim of this study was to investigate whether 20 mEq of Mg supplementation is more effective than 8 mEq Mg in preventing CDDP-induced nephrotoxicity, as well as the associated risk factors, in cancer patients treated with CDDP-based chemotherapy. Methods Pooled data of 272 patients receiving 20 mEq or 8mEq Mg supplementation to CDDP-based chemotherapy from a multicenter, retrospective, observational study were compared using propensity score matching. Separate multivariate logistic regression analyses were used to identify the risk factors for renal failure induced by each treatment dose. Results There was no significant difference in the incidence of CDDP-induced nephrotoxicity between the 8 mEq and 20 mEq groups (18.4% vs. 20.6%, P = 0.760). There was also no significant difference in the severity of nephrotoxicity, elevated serum creatinine levels, and decreased estimated creatinine clearance levels between the two groups. Cardiac disease and albumin levels were identified as independent risk factors for CDDP-induced nephrotoxicity. Conclusion We did not find an advantage of 20 mEq over 8 mEq Mg supplementation in terms of a preventive effect against CDDP-induced nephrotoxicity. The optimal dose of Mg supplementation for the prevention of CDDP-induced nephrotoxicity remains unknown, and further studies are warranted.
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