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

• Main Authors: Liu JQ, Cai GY, Wang SY, Song YH, Xia YY, Liang S, Wang WL, Nie SS, Feng Z, Chen XM
• Format: Article
• Language: English
• Published: Dove Medical Press 2018-07-01
• Series: Therapeutics and Clinical Risk Management
• Subjects: Cisplatin-induced acute kidney injury; elderly; clinical characteristics; risk factors
• Online Access: https://www.dovepress.com/the-characteristics-and-risk-factors-for-cisplatin-induced-acute-kidne-peer-reviewed-article-TCRM

Jie-qiong Liu,1,2 Guang-yan Cai,1 Si-yang Wang,1 Yu-huan Song,1 Yuan-yuan Xia,1 Shuang Liang,1 Wen-ling Wang,1 Sa-sa Nie,1 Zhe Feng,1 Xiang-mei Chen1 1Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Disease, Beijing, China; 2Department of Nephrology, Chinese PLA 401 Hospital, Qingdao, China 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 application of cisplatin (OR 2.853, 95% CI: 1.229, 6.621, p = 0.015) and ACEI/ARB use (OR 3.398, 95% CI: 1.352, 8.545, p = 0.009) were predictive factors for developing CIA in the elderly. Conclusion: The incidence of CIA in the elderly was higher than in younger patients. ACEI/ARB usage and administration of a single application of cisplatin were independent risk factors for CIA in the elderly. Keywords: cisplatin-induced acute kidney injury, elderly, clinical characteristics, risk factors