title: Cisplatin nephrotoxicity aggravated by cardiovascular disease and diabetes in lung cancer patients.
abstract: Ageing lung cancer patients may be at increased risk of Cisplatin (Cp) nephrotoxicity, because of comorbidities leading to accelerated ageing of the kidneys. Therefore, the Cp-induced impairement of renal function was compared between no comorbidity (NC) and hypertension plus ischaemic heart disease (CD) patients or others having diabetes mellitus plus ischaemic heart disease (DMIH). In a preliminary study, glomerular filtration rate (GFR) was measured by clearance of technetium 99m-labelled diethylene-thiamine penta-acetate in 38 lung cancer patients with normal serum creatinine concentration ([creat]). Then, the incidence of nephrotoxicity was analysed retrospectively over 1st-4th cycles of Cp treatment among 242 lung cancer patients with initially normal [creat]. GFR was repeatedly estimated using calculated creatinine clearance. Pre-treatment GFR was 57 ± 3 mL·min⁻¹·m⁻² in those with normal (n = 15) and 42 ± 2 mL·min⁻¹·m⁻² in those with pathologically increased (n = 23) [creat] any time following their 2nd-4th Cp cycle (p < 0.05). The retrospective analysis revealed that Cp-induced nephrotoxicity developed in 7.5% of the NC (n = 80), in 20.9% of the CD (n = 110) and in 30.8% of the DMIH (n = 52) subgroups. Within the overall dropout rate from further Cp chemotherapy, nephrotoxicity was responsible in 14% of NC, 38% in CD and 75% in DMIH patients. A major portion of our ageing lung cancer patients suffered from comorbidities leading to reduced renal resistance to Cp nephrotoxicity.
authors.affiliation: Dept of Pulmonology, Semmelweis University, Budapest, Hungary.
authors.forename: C
authors.initials: C
authors.lastname: Máthé
authors.forename: A
authors.initials: A
authors.lastname: Bohács
authors.forename: L
authors.initials: L
authors.lastname: Duffek
authors.forename: J
authors.initials: J
authors.lastname: Lukácsovits
authors.forename: Z I
authors.initials: ZI
authors.lastname: Komlosi
authors.forename: K
authors.initials: K
authors.lastname: Szondy
authors.forename: I
authors.initials: I
authors.lastname: Horváth
authors.forename: V
authors.initials: V
authors.lastname: Müller
authors.forename: G
authors.initials: G
authors.lastname: Losonczy
mesh_terms: D000375:Aging; D000970:Antineoplastic Agents / Q000633:toxicity; D002318:Cardiovascular Diseases / Q000150:complications*; D002945:Cisplatin / Q000633:toxicity*; D003404:Creatinine / Q000378:metabolism; D048909:Diabetes Complications / Q000378:metabolism*; D005260:Female; D005919:Glomerular Filtration Rate; D006321:Heart / Q000187:drug effects; D006801:Humans; D007511:Ischemia; D007668:Kidney / Q000187:drug effects*; D008111:Liver Function Tests; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016284:Technetium Tc 99m Pentetate / Q000494:pharmacology
chemical_list: D000970:Antineoplastic Agents; D003404:Creatinine; D002945:Cisplatin; D016284:Technetium Tc 99m Pentetate