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妇科癌症中顺铂诱导肾毒性危险因素的多变量分析。

Multivariate analysis of risk factors for cisplatin-induced nephrotoxicity in gynecological cancer.

作者信息

Yamamoto Yoshihiro, Watanabe Kazushi, Matsushita Hiroshi, Tsukiyama Ikuto, Matsuura Katsuhiko, Wakatsuki Akihiko

机构信息

Department of Pharmacy, Aichi Medical University School of Medicine, Aichi, Japan.

Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Aichi, Japan.

出版信息

J Obstet Gynaecol Res. 2017 Dec;43(12):1880-1886. doi: 10.1111/jog.13457. Epub 2017 Oct 6.

Abstract

AIM

Risk factors for cisplatin-induced nephrotoxicity (CIN) vary by population. This study aimed to assess risk factors for CIN in patients with gynecological cancer.

METHODS

Patients who underwent cisplatin-based chemotherapy for gynecological cancer between January 2009 and December 2015 at Aichi Medical University School of Medicine were included in this study. CIN was defined according to the 'risk, injury, failure, loss, and end-stage kidney disease' (RIFLE) criteria and classified as either risk (Class R) or injury (Class I). Analyses were performed using univariate and multivariate logistic regression models.

RESULTS

Among 112 patients enrolled, 30 had CIN. Multivariate analysis revealed that hydration with magnesium (odds ratio [OR], 0.223), history of cisplatin use (OR, 4.420), and hypoalbuminemia (OR, 4.170) were risk factors for Class R, and that frequency of cisplatin administration (OR, 5.620) and hydration with magnesium (OR, 0.216) were risk factors for Class I.

CONCLUSION

This study confirmed that hydration without magnesium, history of cisplatin use, frequency of cisplatin administration, and hypoalbuminemia are significant risk factors for CIN.

摘要

目的

顺铂诱导的肾毒性(CIN)的危险因素因人群而异。本研究旨在评估妇科癌症患者中CIN的危险因素。

方法

纳入2009年1月至2015年12月在爱知医科大学医学院接受基于顺铂化疗的妇科癌症患者。CIN根据“风险、损伤、衰竭、丧失和终末期肾病”(RIFLE)标准定义,并分为风险(R级)或损伤(I级)。使用单变量和多变量逻辑回归模型进行分析。

结果

在纳入的112例患者中,30例发生CIN。多变量分析显示,镁水化(比值比[OR],0.223)、顺铂使用史(OR,4.420)和低白蛋白血症(OR,4.170)是R级的危险因素,顺铂给药频率(OR,5.620)和镁水化(OR,0.216)是I级的危险因素。

结论

本研究证实,无镁水化、顺铂使用史、顺铂给药频率和低白蛋白血症是CIN的重要危险因素。

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