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已发表论文
顺铂诱导的老年人急性肾损伤的特点及危险因素
Authors Liu JQ, Cai GY, Wang SY, Song YH, Xia YY, Liang S, Wang WL, Nie SS, Feng Z, Chen XM
Received 14 February 2018
Accepted for publication 6 April 2018
Published 25 July 2018 Volume 2018:14 Pages 1279—1285
DOI https://doi.org/10.2147/TCRM.S165531
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Professor Deyun Wang
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
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
