Incidence of Cisplatin-Induced Nephrotoxicity and Associated Factors among Cancer Patients in Indonesia

Abstract

<b>Background:</b> Cisplatin is still used as a first-line medication for solid tumors. Nephrotoxicity is a serious sideeffect that can decrease renal function and restrict applicable doses. This research aimed to obtain the profile ofcisplatin-induced nephrotoxicity and its associated factors in adult cancer patients at Dharmais National CancerHospital (DNCH). Materials and <br/><b>Methods</b>: The design was cross-sectional with data obtained from patientmedical records. We retrospectively reviewed adult cancer patients treated with cisplatin ≥60mg/m2 for at leastfour consecutive chemotherapy cycles from August 2011 to November 2013. The nephrotoxicity criterion wasrenal function decline characterized by creatinine clearance <60 ml/min using the Cockroft-Gault (CG) equation.<br/><b>Results</b>: Eighty-eight subjects received at least four chemotherapy cycles of cisplatin. The prevalence of cisplatinnephrotoxicity was 34.1%. Symptoms could be observed after the first cycle of chemotherapy, and the degree ofrenal impairment was higher with increased numbers of cycles (r=-0.946, r2=89.5%). Factors that affected thedecline of renal function were patient age (p=0.008, OR=3.433, 95%CI= 1.363-8.645) and hypertension (p=0.026,OR=2.931, 95%CI=1.120-7.670). <br/><b>Conclusions</b>: Cisplatin nephrotoxicity occurred in more than one-third ofpatients after the fourth cycle of chemotherapy and worsened after each cycle despite preventive strategies suchas hydration. The decline of renal function induced by cisplatin ≥60 mg/m2 was affected by age and hypertension.