Division of Clinical Sciences and Neuropsychopharmacology, Faculty of Pharmacy, Meijo University, Nagoya, Japan.
Oncology. 2013;85(6):364-9. doi: 10.1159/000356587. Epub 2013 Dec 7.
We reported that the KDIGO (Kidney Disease: Improving Global Outcomes) criteria could stratify the risk of mortality in acute kidney injury (AKI) caused by cisplatin. The purpose of this study was to investigate risk factors of severe cisplatin-induced AKI (CIA).
From January 2006 to December 2012, we identified Japanese cancer patients who were treated with cisplatin as a first-line chemotherapy at Nagoya University Hospital. Serum creatinine levels were used to define CIA.
We evaluated 1,721 patients treated with cisplatin. In multivariable analysis, cisplatin dosages/m(2) [odds ratio (OR) 1.019] or diagnosis of cancer stage 4 (OR 1.797) were risk factors of moderate CIA. History of diabetes mellitus (OR 3.454), history of cardiovascular disease (OR 3.612) or diagnosis of cancer stage 4 (OR 2.610) were risk factors of severe CIA.
Diabetes mellitus, cardiovascular disease and advanced cancer increased the risk of severe CIA. As severe CIA shortens the survival period, we should consider whether the use of cisplatin benefits these patients.
我们曾报道 KDIGO（改善全球肾脏病预后组织）标准可对顺铂所致急性肾损伤（AKI）的死亡风险进行分层。本研究旨在探讨严重顺铂诱导 AKI（CIA）的危险因素。
本研究回顾性分析了 2006 年 1 月至 2012 年 12 月在名古屋大学医院接受顺铂作为一线化疗的日本癌症患者。使用血清肌酐水平来定义 CIA。
共评估了 1721 例接受顺铂治疗的患者。多变量分析显示，顺铂剂量/体表面积（OR=1.019）或癌症 4 期诊断（OR=1.797）是 CIA 中度的危险因素。糖尿病史（OR=3.454）、心血管疾病史（OR=3.612）或癌症 4 期诊断（OR=2.610）是 CIA 重度的危险因素。
糖尿病、心血管疾病和晚期癌症增加了 CIA 重度的风险。由于 CIA 重度会缩短生存期，我们应考虑顺铂治疗是否会使这些患者受益。
