title: Does the number of cycles of cisplatin based chemotherapy have any effect on renal function in patients with testicular germ cell tumor?
abstract: OBJECTIVE
  We assessed the effects of the number of cisplatin, etoposide and bleomycin cycles on long-term renal function.
  
  
  METHODS
  A total of 157 patients with primary testicular germ cell tumors were treated between 1995 and 2013, of whom 113 (72%) received chemotherapy as the primary intervention. Data were collected retrospectively. The estimated glomerular filtration rate was determined using the Modification of Diet in Renal Disease (MDRD) formula based on pretreatment and last followup visit serum creatinine measurements. Patients who did not receive chemotherapy were compared to those who received cisplatin based chemotherapy. The chemotherapy group was also divided into 3 subgroups according to the number of chemotherapy cycles (2, 3, or 4 or more).
  
  
  RESULTS
  At the last followup visit serum creatinine and the estimated glomerular filtration rate significantly differed between the chemotherapy and nonchemotherapy groups. The decrease in the median estimated glomerular filtration rate was significantly greater in the chemotherapy than the nonchemotherapy group (p<0.001). New onset stage 3 chronic kidney disease was observed in 19 patients (12.1%) in the chemotherapy group, including 0%, 5.9%, 13.8% and 20.9% who received 0, 2, 3, or 4 or more chemotherapy cycles, respectively. Except for the difference between the nonchemotherapy group and the 2-cycle chemotherapy group the differences between the groups in new onset chronic stage 3 kidney disease were statistically significant.
  
  
  CONCLUSIONS
  Patients with testicular tumors who received cisplatin based chemotherapy showed a significant decrease in the estimated glomerular filtration rate and a significant increase in new onset stage 3 chronic kidney disease compared to patients who received no cycle. However, in patients at high risk with stage I nonseminomatous germ cell tumor who elected 2 cycles of cisplatin, etoposide and bleomycin the chemotherapy had no statistically significant effect on these parameters compared to those in patients who received no chemotherapy.
authors.affiliation: Department of Urology, University of Ankara, Ankara, Turkey.
authors.forename: Evren
authors.initials: E
authors.lastname: Suer
authors.forename: Murat
authors.initials: M
authors.lastname: Mermerkaya
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Gülpınar
authors.forename: Faraj
authors.initials: F
authors.lastname: Afandiyev
authors.forename: Sümer
authors.initials: S
authors.lastname: Baltacı
authors.forename: Kadir
authors.initials: K
authors.lastname: Türkölmez
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Bedük
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D001761:Bleomycin / Q000008:administration & dosage* / Q000494:pharmacology; D002945:Cisplatin / Q000008:administration & dosage* / Q000494:pharmacology; D003404:Creatinine / Q000097:blood; D005047:Etoposide / Q000008:administration & dosage* / Q000494:pharmacology; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology*; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000503:physiopathology*; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001761:Bleomycin; D005047:Etoposide; D003404:Creatinine; D002945:Cisplatin
keywords: CKD; GCT; GFR; NSGCT; PEB; chronic; chronic kidney disease; cisplatin; cisplatin, etoposide and bleomycin; eGFR; estimated GFR; germ cell and embryonal; germ cell tumor; glomerular filtration rate; kidney; neoplasms; nonseminomatous GCT; renal insufficiency; testis