Safety of a short hydration method for cisplatin administration in comparison with a conventional method—a retrospective study

Sakaida, Emiko; Iwasawa, Shunichiro; Kurimoto, Ryota; Ebata, Takahiro; Imai, Chiaki; Oku, Tomoko; Sekine, Ikuo; Tada, Yuji; Takiguchi, Yuichi

doi:10.1093/jjco/hyv203

Cited by 13 publications

(12 citation statements)

References 25 publications

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“…In their study, the administration of mannitol as a diuretic and magnesium supplementation were only performed in the SH group. 20 In the presently reported study, 467 patients divided into two groups received the same antiemetics and mannitol treatment, and most of the patients also received magnesium supplementation. Nevertheless, a significant difference in the incidence of renal toxicity was observed between the two methods of hydration.…”

Section: Discussionmentioning

confidence: 99%

Reduction in nephrotoxicities using short hydration for chemotherapy containing cisplatin: a consecutive analysis of 467 patients with thoracic malignancies

Tanaka

Horinouchi²,

Goto³

et al. 2018

ESMO Open

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BackgroundConventional hydration (CH) in chemotherapy containing cisplatin (CDDP) has been recommended to prevent renal toxicity. Although an increasing number of studies have demonstrated the feasibility of short hydration (SH), few large studies have reported the superiority of SH, compared with CH, in terms of nephrotoxicities.MethodsWe conducted a consecutive retrospective analysis of 467 patients who had been treated with chemotherapy including CDDP. Statistical analyses were performed to evaluate the risk factors for nephrotoxicities. The following factors were included in the analyses: age, sex, performance status (PS), concomitant thoracic radiotherapy, CDDP dose, magnesium supplementation, baseline creatinine values and method of hydration.ResultsThe patients’ characteristics were as follows: male/female, 323/144 patients; median age (range), 62 (27–69) years; PS 0/1/2/3, 238/217/10/2 patients and SH/CH, 111/356 patients. The proportion of patients requiring a CDDP dose reduction in the SH group was 6.3%, while that in the CH group was 12.9%. Patients who discontinued CDDP because of nephrotoxicities accounted for 0.9% of the patients in the SH group and 2.2% of the patients in the CH group. After CDDP-based chemotherapy, a creatinine increase of more than grade 1 was observed in 14.4% and 33.1% of the patients in the SH and CH groups, respectively. A logistic regression analysis revealed a significantly lower incidence of grade 1 or higher creatinine toxicity after the first cycle of chemotherapy in the SH group (OR, 0.20; 95% CI 0.06 to 0.63; p=0.006).ConclusionsSH resulted in a significantly lower incidence of nephrotoxicity.

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Section: Discussionmentioning

confidence: 99%

Reduction in nephrotoxicities using short hydration for chemotherapy containing cisplatin: a consecutive analysis of 467 patients with thoracic malignancies

Tanaka

Horinouchi²,

Goto³

et al. 2018

ESMO Open

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“…As patients with advanced cancer tend to be dehydrated [28] , they are at high risk for AKI. To prevent ischemic AKI (both the acute tubular necrosis type and the prerenal azotemia type, which results from renal hypoperfusion), hydration, monitoring of renal function, and administration of magnesium [14,[29][30][31] are conducted. As cisplatin has a high protein binding rate, hypoalbuminemia induced side effects, including myelosuppression, a peripheral nerve disorder, and AKI.…”

Section: Discussionmentioning

confidence: 99%

Lower Blood Pressure-Induced Renal Hypoperfusion Promotes Cisplatin-Induced Nephrotoxicity

et al. 2016

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Background and Aims: Cisplatin-induced nephrotoxicity primarily occurs in the proximal tubules, and tubular injuries reduce glomerular filtration rates. Lower blood pressure causes renal hypoperfusion, which promotes ischemic acute kidney injury (AKI). Our study examined the relationship between lower blood pressure-induced renal hypoperfusion and cisplatin-induced nephrotoxicity. Methods: The relationship between cisplatin use and hypoalbuminemia is not clear. This study consisted of Japanese patients who received cisplatin as the first-line chemotherapy at Fujita Health University Hospital from April 2006 to December 2012. Hypoalbuminemia was defined as serum albumin levels ≤3.5 mg/dl. Results: Patients who experienced lower blood pressure during chemotherapy were included in the lower blood pressure group (n = 229), and those who did not were included in the normal blood pressure group (n = 743). Total cisplatin dose in the normal blood pressure and lower blood pressure groups was 58.9 ± 23.8 and 55.0 ± 20.4 mg/m², respectively. The rate of severe nephrotoxicity was higher and overall survival was shorter in the lower blood pressure group than in the normal blood pressure group. In a multivariable analysis, lower blood pressure significantly correlated with hypoalbuminemia. Conclusions: To prevent ischemic AKI, nutrition and cachexia controlling are important parts of cancer treatment.

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“…5 Other studies conducted on the effect of short versus long hydration schemes have the same limitation as HYCIS1. [5][6][7][8][9][10][11][12][13][14][15] In order to inventorize the different cisplatin hydration schemes used in Dutch hospitals, we sent a survey to Dutch hospital pharmacies. Results of this survey showed that the cisplatin hydration schemes vary widely among hospitals and even within hospitals, depending on the indication and concomitant chemotherapy medication.…”

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

“…Change in estimated glomerular filtration rate [Correction added on 01 September 2020, after first online publication: The P values in Table 3 have been transposed] The impact on SH versus LH scheme has been studied in previous reports as well, including HYCIS1. [5][6][7][8][9][10][11][12][13][14][15] In these reports, an SH proved to be associated with less or comparable nephrotoxicity. However, in these studies, many other factors differed between treatment groups as well, such as starting dose and administration rate of cisplatin, hydration fluid, electrolyte additives and diuretic use, which may have affected these results.…”

Section: Ta B L Ementioning

confidence: 99%

Difference in decline in renal function due to cisplatin after a short or long hydration scheme in non–small‐cell lung cancer: A retrospective cohort study (HYCIS‐XL)

et al. 2020

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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 Fifty patients were included in the SH and LH group. There were no significant differences in baseline characteristics between the two groups. None of the patients had renal failure at baseline. After two cisplatin cycles, the median differences between the baseline eGFR and the eGFR after the last cisplatin dose were 1 (−6 to 5) and −9 (−22 to −2) mL/min/1.73 m2 (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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Safety of a short hydration method for cisplatin administration in comparison with a conventional method—a retrospective study

Cited by 13 publications

References 25 publications

Reduction in nephrotoxicities using short hydration for chemotherapy containing cisplatin: a consecutive analysis of 467 patients with thoracic malignancies

Reduction in nephrotoxicities using short hydration for chemotherapy containing cisplatin: a consecutive analysis of 467 patients with thoracic malignancies

Lower Blood Pressure-Induced Renal Hypoperfusion Promotes Cisplatin-Induced Nephrotoxicity

Difference in decline in renal function due to cisplatin after a short or long hydration scheme in non–small‐cell lung cancer: A retrospective cohort study (HYCIS‐XL)

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