title: The impact of a solitary kidney on tolerability to gemcitabine plus cisplatin chemotherapy in urothelial carcinoma patients: a retrospective study.
abstract: OBJECTIVE
  There is little information on tolerability to cisplatin-based chemotherapies in patients with a solitary kidney after nephroureterectomy. We evaluated the impact of having a solitary kidney on tolerability to gemcitabine plus cisplatin (GC) chemotherapy in urothelial carcinoma patients.
  
  
  METHODS
  We retrospectively reviewed medical records of patients treated between August 2007 and November 2015. Eligible patients had received GC as first-line chemotherapy, including as neoadjuvant and adjuvant treatment. Patients who commenced GC chemotherapy after nephroureterectomy comprised the solitary kidney (SK) group; the remaining patients (i.e., those with both kidneys) comprised the BK group. Incidences of hematologic toxicities and renal insufficiency were examined and compared between two groups.
  
  
  RESULTS
  There were 16 patients in the SK group and 31 in the BK group. The incidence of hematologic toxicity (grade 3/4) was not significantly different between the two groups (neutropenia: 68.8 vs. 74.2%, respectively (P = 0.959); thrombocytopenia: 31.2 vs. 51.6%, respectively (P = 0.307); and anemia: 12.5 vs. 38.7%, respectively (P = 0.094)). Multivariate analysis revealed no statistically significant association between having a SK and severe hematologic toxicities. Moreover, no significant differences were observed in the incidence of acute kidney injury. The mean differences in serum creatinine and estimated glomerular filtration rate between baseline and each post-chemotherapy cycle were similar when comparing the SK and BK groups.
  
  
  CONCLUSIONS
  There is no evidence that tolerability to GC chemotherapy is inferior in patients with a solitary kidney. Therefore, there may be no need to avoid administering CDDP-based chemotherapy to such patients.
authors.affiliation: Department of Pharmacy, Nagoya City University Hospital, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8602, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kondo
authors.affiliation: Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, 3-1, Tanabe dori, Mizuho ku, Nagoya, 467-8603, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hotta
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8602, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Ando
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8602, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yasui
authors.affiliation: Department of Pharmacy, Nagoya City University Hospital, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8602, Japan. kkimura@med.nagoya-cu.ac.jp.|Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, 3-1, Tanabe dori, Mizuho ku, Nagoya, 467-8603, Japan. kkimura@med.nagoya-cu.ac.jp.|Department of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8602, Japan. kkimura@med.nagoya-cu.ac.jp.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kimura
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009503:Neutropenia / Q000139:chemically induced / Q000453:epidemiology; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine
keywords: Cisplatin; Hematologic toxicities; Nephroureterectomy; Renal safety; Solitary kidney; Tolerability