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BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

Lower blood pressure and risk of cisplatin nephrotoxicity: a retrospective cohort study

Authors: Kazumi Komaki, Tetsuro Kusaba, Mai Tanaka, Hiroshi Kado, Yayoi Shiotsu, Masahiro Matsui, Atsushi Shiozaki, Hiroshi Nakano, Takeshi Ishikawa, Hitoshi Fujiwara, Hideyuki Konishi, Yoshito Itoh, Satoaki Matoba, Keiichi Tamagaki

Published in: BMC Cancer | Issue 1/2017

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Abstract

Background

The pathophysiological mechanisms of cisplatin nephrotoxicity include the reduction of renal blood flow, as well as tubular epithelial cell toxicity. The objective of this study was to investigate the influence of lower blood pressure and decreased food intake on the incidence of cisplatin nephrotoxicity.

Methods

We conducted a retrospective cohort study at a university hospital between 2011 and 2012. We identified hospitalized adult patients with head and neck cancer, esophageal cancer, or gastric cancer, who received intravenous cisplatin administration. The primary outcome was the incidence of cisplatin nephrotoxicity defined as the increase in serum creatinine after cisplatin administration more than 1.5 times from baseline.

Results

The study participants included 182 patients, in whom we observed a total of 442 cycles of cisplatin chemotherapy. The incidence of cisplatin nephrotoxicity was observed in 41 of 182 cycles with initial administration. Multivariate logistic regression analysis showed that systolic blood pressure was independently associated with cisplatin nephrotoxicity (adjusted odds ratio 0.75, 95% confidence interval 0.57 to 0.95 for each 10 mmHg). The use of renin-angiotensin system (RAS) inhibitors was also associated with cisplatin nephrotoxicity (3.39, 1.30 to 8.93). Among quartiles of systolic blood pressure in all cycles of chemotherapy, the incidence of nephrotoxicity in the lower blood pressure group was significantly higher than that in the higher blood pressure group for patients taking non-solid food (P = 0.037), while there was no significant difference for patients taking solid food (P = 0.67).

Conclusions

Lower blood pressure and the use of RAS inhibitors were associated with the incidence of cisplatin nephrotoxicity, and lower blood pressure had a greater influence on nephrotoxicity in patients who could not take solid food. Discontinuation of antihypertensive medication including RAS inhibitors before cisplatin chemotherapy should be considered, which may be beneficial for patients with lower blood pressure.
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Metadata
Title
Lower blood pressure and risk of cisplatin nephrotoxicity: a retrospective cohort study
Authors
Kazumi Komaki
Tetsuro Kusaba
Mai Tanaka
Hiroshi Kado
Yayoi Shiotsu
Masahiro Matsui
Atsushi Shiozaki
Hiroshi Nakano
Takeshi Ishikawa
Hitoshi Fujiwara
Hideyuki Konishi
Yoshito Itoh
Satoaki Matoba
Keiichi Tamagaki
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3135-6

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