Risk factors for cisplatin-induced nephrotoxicity and potential of magnesium supplementation for renal protection
Kidera Y, Kawakami H, Sakiyama T, Okamoto K, Tanaka K, Takeda M, Kaneda H, Nishina S, Tsurutani J, Fujiwara K, Nomura M, Yamazoe Y, Chiba Y, Nishida S, Tamura T, Nakagawa K
PloS one · 89 citations
How it was studied
- Design
- Cohort study (classified by our AI screen)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Government
- Japan Society for the Promotion of Science
- Grants
- Japan Society for the Promotion of Science (24701037)
Based on 1 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2014-07-14 · PLoS One · vol. 9 · issue 7 · p. e101902
- Publisher
- Public Library of Science
- Cited
- 130 citations · more than 98% of similar papers · 8.3× the field average
- Impact
- Top 10% most cited in its field
- References
- 32 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Chemotherapy-induced organ toxicity mitigation · Magnesium in Health and Disease · Silymarin and Mushroom Poisoning
- Keywords
- Nephrotoxicity, Medicine, Hypomagnesemia, Creatinine, Cisplatin, Common Terminology Criteria for Adverse Events, Toxicity, Internal medicine, Renal function, Urology, Chemotherapy, Acute kidney injury, Adverse effect, Gastroenterology, Pharmacology, Magnesium, Chemistry
- MeSH
- humans, neoplasms, kidney diseases, cisplatin, magnesium, creatinine, multivariate analysis, odds ratio, risk factors, retrospective studies, dna mutational analysis, dietary supplements
16 authors
From JP
- Yasuhiro KideraKindai University
- Hisato Kawakami · correspondingKindai University
- Tsutomu SakiyamaKindai University
- Kunio OkamotoKindai University
- Kaoru TanakaKindai University
- Masayuki TakedaKindai University
Abstract
Background
Nephrotoxicity remains a problem for patients who receive cisplatin chemotherapy. We retrospectively evaluated potential risk factors for cisplatin-induced nephrotoxicity as well as the potential impact of intravenous magnesium supplementation on such toxicity.
Patients and methods
We reviewed clinical data for 401 patients who underwent chemotherapy including a high dose (≥60 mg/m2) of cisplatin in the first-line setting. Nephrotoxicity was defined as an increase in the serum creatinine concentration of at least grade 2 during the first course of cisplatin chemotherapy, as assessed on the basis of National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. The severity of nephrotoxicity was evaluated on the basis of the mean change in the serum creatinine level. Magnesium was administered intravenously to 67 patients (17%).
Results
Cisplatin-induced nephrotoxicity was observed in 127 patients (32%). Multivariable analysis revealed that an Eastern Cooperative Oncology Group performance status of 2 (risk ratio, 1.876; P = 0.004) and the regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) (risk ratio, 1.357; P = 0.047) were significantly associated with an increased risk for cisplatin nephrotoxicity, whereas intravenous magnesium supplementation was associated with a significantly reduced risk for such toxicity (risk ratio, 0.175; P = 0.0004). The development of hypomagnesemia during cisplatin treatment was significantly associated with a greater increase in serum creatinine level (P = 0.0025). Magnesium supplementation therapy was also associated with a significantly reduced severity of renal toxicity (P = 0.012).
Conclusions
A relatively poor performance status and the regular use of NSAIDs were significantly associated with cisplatin-induced nephrotoxicity, although the latter association was marginal. Our findings also suggest that the ability of magnesium supplementation to protect against the renal toxicity of cisplatin warrants further investigation in a prospective trial.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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