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Administration of contrast media just before the cisplatin-based chemotherapy increases the cisplatin-induced nephrotoxicity.
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2012
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Renal PathologyRenal InflammationPharmacotherapyMetronomic ChemotherapyGlomerulonephritisRenal FunctionContrast MediaOncologyCisplatin-based ChemotherapyIga GlomerulonephritisMetronomic TherapyChronic Kidney DiseaseRenal PharmacologyCancer ResearchRadiologyRenal CareKidney FailureRenal PathophysiologyContrast AgentPharmacologyUrologyRenal DiseaseCisplatin-induced NephrotoxicityE13031 BackgroundMedicineNephrologyKidney Research
e13031 Background: The most important dose-limiting manifestation of cisplatin is renal tubular dysfunction and a cumulative impairment in renal function, as manifested by a decline in the glomerular filtration rate (GFR). There is a clinical need to predict the probability of cisplatin-induced nephrotoxicity (CIN), in order to support decisions about patient management and preventive measures. The aim of the present study was to develop risk prediction of CIN. Methods: Consecutive 197 patients with documented serum creatinine before at least 48 hours every cycle cisplatin-based chemotherapy were included the study. Demographic and medical data including age, performance status, tumor characteristics and comorbid diseases were collected from the medical charts. Renal function was evaluated for each cycle before treatment (day 0) and before next cycle (day 21) based on the Modification of Diet in Renal Disease (MDRD) formula. Cisplatin-induced nephrotoxicity (CIN) was defined as decrease of ≥ 25% in GFR compared to baseline GFR values. Results: The mean age of the study population was 54.5±9.6 years. Baseline MDRD levels had decreased of ≥ 25% in 58 (29.4%) patients accepted as CIN group, the rest of 139 patients of the study population accepted as a non-CIN group. There was no difference of age, gender, body mass index and smoking history between groups. In both group, the hypertension (p=0.81), diabetes mellitus (p=0.72), and cardiovascular disease (p=0.58) were seen equally. Types of concomitant therapy with cisplatin-based chemotherapy were similar between CIN and non-CIN groups. The applied radiologic examinations with contrast media was observed higher in CIN group than non-CIN group (P=0.01). In patients exposure the contrast media within one week before cisplatin administration, the risk of CIN was observed 2.56 (95%CI: 1.28-5.11) times higher than in patients not exposure to the contrast (p=0.009). Conclusions: In patients exposure the contrast media within one week before cisplatin administration, the risk of CIN was observed higher than in patients not exposure to the contrast. No additional risk factor of CIN was found in this retrospective observational study.