The characteristics and risk factors for cisplatin-induced acute kidney injury in the elderly

作者：Jieqiong Liu, Guangyan Cai, Siyang Wang, Yu-Huan Song, Yuanyuan Xia, Shuang Liang, Wenling Wang, Sa-sa Nie, Zhe Feng, Xiangmei Chen · 发表于：Therapeutics and Clinical Risk Management · 年份：2018 · DOI：10.2147/tcrm.s165531 · 被引用次数：30 · 研究领域：Chemotherapy-induced organ toxicity mitigation、Acute Kidney Injury Research、Chemotherapy-induced cardiotoxicity and mitigation

Objectives: The most serious adverse reaction of cisplatin is acute kidney injury (AKI). Cisplatin-induced acute kidney injury (CIA) has no specific preventive measures. This study aims to explore the characteristics and risk factors for CIA in the elderly and to identify potential methods to reduce CIA. Materials and methods: Patients ≥18 years old, with primary tumors, who received initial cisplatin chemotherapy and whose serum creatinine (SCr) values were measured within 2 weeks pre- and postcisplatin treatment and who had complete medical records, were selected from a single center from January 1, 2013 to December 31, 2015. The exclusion criteria included radiotherapy or surgery, recurrent tumors, previous cisplatin treatment, lack of any SCr values before or after cisplatin therapy, and incomplete medical records. Results: Out of a total of 527 patients, 349 were elderly. Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) use (9.2%) was more prevalent in the elderly than in younger patients (2.8%, p = 0.007). The dosage of cisplatin treatment was lower in the elderly, but the incidence of CIA (9.46%) was higher in the elderly than in younger patients (3.37%). There were significant differences in the SCr levels, estimated glomerular filtration rate, ACEI/ARB use, and whether a single application of cisplatin was administered, between the elderly AKI group and the non-AKI group. Multivariable analysis showed that administration of a single app...