Renal Division, Department of Internal Medicine, Iwata City Hospital, Iwata, Japan.
Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
PLoS One. 2020 Feb 21;15(2):e0229377. doi: 10.1371/journal.pone.0229377. eCollection 2020.
Cisplatin is a highly effective chemotherapeutic agent. However, acute kidney injury (AKI) limits its subsequent use, resulting in poor cancer prognosis. Dipeptidyl peptidase-4 (DPP-4) inhibitors have been reported to attenuate cisplatin-induced AKI in animal models, but the effect in human patients remains to be clarified. We hypothesized that DPP-4 inhibitors can prevent cisplatin-induced AKI in diabetic-cancer patients.
We retrospectively reviewed all consecutive cancer patients who were treated with a first cycle of cisplatin-containing regimen between January 2011 and October 2019. We analysed data of diabetic-cancer patients treated with high-dose cisplatin (> 50 mg/m2)-containing regimens. The change of estimated glomerular filtration rate (eGFR) within 2 weeks after cisplatin treatment was compared between the patients treated with DPP-4 inhibitors and those treated without DPP-4 inhibitors.
A total of 455 patients were treated with cisplatin during the period. Of these, 34 patients were eligible for the analysis. The change of eGFR was significantly less in the patients treated with DPP-4 inhibitors, compared to those without DPP-4 inhibitors [the percentages of eGFR decline (mean ± SD) was 23.6 ± 20.3% vs 43.1± 20.1%, respectively; P = 0.010]. Furthermore, the incidence of AKI was significantly less in the patients treated with DPP-4 inhibitors (25% vs 64%, respectively; P = 0.026).
DPP-4 inhibitors may decrease the risk of cisplatin-induced AKI in diabetic patients.
顺铂是一种高效的化疗药物。然而，急性肾损伤（AKI）限制了其后续使用，导致癌症预后不良。二肽基肽酶-4（DPP-4）抑制剂已被报道可减轻动物模型中的顺铂诱导的 AKI，但在人类患者中的效果仍有待阐明。我们假设 DPP-4 抑制剂可预防糖尿病合并癌症患者的顺铂诱导的 AKI。
我们回顾性分析了 2011 年 1 月至 2019 年 10 月期间接受含顺铂方案治疗的所有连续癌症患者。我们分析了接受高剂量顺铂（> 50mg/m2）方案治疗的糖尿病合并癌症患者的数据。比较了顺铂治疗后 2 周内接受 DPP-4 抑制剂治疗和未接受 DPP-4 抑制剂治疗的患者的估算肾小球滤过率（eGFR）变化。
在此期间，共有 455 例患者接受了顺铂治疗。其中，34 例符合分析条件。与未接受 DPP-4 抑制剂治疗的患者相比，接受 DPP-4 抑制剂治疗的患者 eGFR 的下降幅度明显较小[eGFR 下降百分比（平均值±标准差）分别为 23.6%±20.3%和 43.1%±20.1%；P = 0.010]。此外，接受 DPP-4 抑制剂治疗的患者 AKI 的发生率明显较低（分别为 25%和 64%；P = 0.026）。
DPP-4 抑制剂可能降低糖尿病患者顺铂诱导的 AKI 的风险。
