Incidence of Cisplatin-Induced Nephrotoxicity and Associated Factors among Cancer Patients in Indonesia

• DOI: 10.7314/apjcp.2015.16.3.1117
• Publication Date: 2015-04-16T02:08:07Z
• Authors: Yenny Prasaja; Noorwati Sutandyo; Retnosari Andrajati
• Keywords: Adult; Male; Incidence; Antineoplastic Agents; Comorbidity; Middle Aged; Prognosis; 3. Good health; Survival Rate; 03 medical and health sciences; Cross-Sectional Studies; 0302 clinical medicine; Creatinine; Neoplasms; Humans; Female; Kidney Diseases; Cisplatin; Follow-Up Studies; Glomerular Filtration Rate; Neoplasm Staging; Retrospective Studies

Cisplatin is still used as a first-line medication for solid tumors. Nephrotoxicity is a serious side effect that can decrease renal function and restrict applicable doses. This research aimed to obtain the profile of cisplatin-induced nephrotoxicity and its associated factors in adult cancer patients at Dharmais National Cancer Hospital (DNCH).The design was cross-sectional with data obtained from patient medical records. We retrospectively reviewed adult cancer patients treated with cisplatin ≥60mg/m2 for at least four consecutive chemotherapy cycles from August 2011 to November 2013. The nephrotoxicity criterion was renal function decline characterized by creatinine clearance <60 ml/min using the Cockroft-Gault (CG) equation.Eighty-eight subjects received at least four chemotherapy cycles of cisplatin. The prevalence of cisplatin nephrotoxicity was 34.1%. Symptoms could be observed after the first cycle of chemotherapy, and the degree of renal impairment was higher with increased numbers of cycles (r=-0.946, r2=89.5%). Factors that affected the decline of renal function were patient age (p=0.008, OR=3.433, 95%CI= 1.363-8.645) and hypertension (p=0.026, OR=2.931, 95%CI=1.120-7.670).Cisplatin nephrotoxicity occurred in more than one-third of patients after the fourth cycle of chemotherapy and worsened after each cycle despite preventive strategies such as hydration. The decline of renal function induced by cisplatin ≥60 mg/m2 was affected by age and hypertension.