title: Risk Factors Associated with Cisplatin-Induced Nephrotoxicity in Patients with Advanced Lung Cancer.
abstract: Cisplatin (CDDP) combination chemotherapy is widely administered to patients with advanced lung cancer. The dose depends on multiple factors, including whether the tumor is non-small-cell lung cancer (NSCLC) or small-cell lung cancer (SCLC). Although efficacy is limited by cisplatin-induced nephrotoxicity (CIN), little is known about the risk factors for this complication. The aim of this study was to identify the risk factors for CIN in patients with advanced lung cancer, both NSCLC and SCLC. We retrospectively reviewed clinical data for 148 patients who underwent initial chemotherapy including CDDP ≥50 mg/m2per patient per day for the first course at Kyushu Medical Center between October 2010 and September 2013. All data were collected from the electronic medical record system. Nephrotoxicity was defined as an increase in serum creatinine concentration of at least grade 2 during the first course of CDDP chemotherapy, as described by the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. CIN was observed in nine patients. Univariate analysis revealed that cardiac disease and lower baseline serum albumin (Alb) values conferred a higher risk of nephrotoxicity (p<0.05). The cut-off value of Alb was 3.8 g/dL, calculated by receiver operating characteristics (ROC) curves. Multivariable logistic regression analysis revealed that cardiac disease (odds ratio=11.7; p=0.002) and hypoalbuminemia (odds ratio=6.99 p=0.025 significantly correlated with nephrotoxicity. In conclusion, cardiac disease and low baseline Alb values are possible risk factors for CIN.
authors.affiliation: Department of Pharmacy, National Hospital Organization Beppu Medical Center.
authors.forename: Takanori
authors.initials: T
authors.lastname: Miyoshi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Misumi
authors.forename: Mikako
authors.initials: M
authors.lastname: Hiraike
authors.forename: Yuki
authors.initials: Y
authors.lastname: Mihara
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishino
authors.forename: Minako
authors.initials: M
authors.lastname: Tsuruta
authors.forename: Yosei
authors.initials: Y
authors.lastname: Kawamata
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiraki
authors.forename: Aki
authors.initials: A
authors.lastname: Kozono
authors.forename: Masao
authors.initials: M
authors.lastname: Ichiki
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000150:complications / Q000188:drug therapy; D002945:Cisplatin / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced* / Q000150:complications; D008175:Lung Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D055752:Small Cell Lung Carcinoma / Q000097:blood / Q000150:complications / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents; D012709:Serum Albumin; D003404:Creatinine; D002945:Cisplatin