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- Title
Cisplatin-induced nephrotoxicity in childhood cancer: comparison between two countries.
- Authors
Zazuli, Zulfan; Op 't Hoog, Catharina J. P.; Vijverberg, Susanne J. H.; Masereeuw, Rosalinde; Rassekh, Shahrad Rod; Medeiros, Mara; Rivas-Ruiz, Rodolfo; Maitland-van der Zee, Anke H.; Carleton, Bruce C.
- Abstract
Background: Various definitions used to describe cisplatin nephrotoxicity potentially lead to differences in determination of risk factors. This study evaluated incidence of kidney injury according to commonly used and alternative definitions in two cohorts of children who received cisplatin. Methods: This retrospective cohort study included children from Vancouver, Canada (one center), and Mexico City, Mexico (two centers), treated with cisplatin for a variety of solid tumors. Serum creatinine–based definitions (KDIGO and Pediatric RIFLE (pRIFLE)), electrolyte abnormalities consisted of hypokalemia, hypophosphatemia and hypomagnesemia (based on NCI-CTCAE v5), and an alternative definition (Alt-AKI) were used to describe nephrotoxicity. Incidence with different definitions, definitional overlap, and inter-definition reliability was analyzed. Results: In total, 173 children (100 from Vancouver, 73 from Mexico) were included. In the combined cohort, Alt-AKI criteria detected more patients with cisplatin nephrotoxicity compared to pRIFLE and KDIGO criteria (82.7 vs. 63.6 vs. 44.5%, respectively). Nephrotoxicity and all electrolyte abnormalities were significantly more common in Vancouver cohort than in Mexico City cohort except when using KDIGO definition. The most common electrolyte abnormalities were hypomagnesemia (88.9%, Vancouver) and hypophosphatemia (24.2%, Mexico City). The KDIGO definition provided highest overlap of cases in Vancouver (100%), Mexico (98.6%), and the combined cohort (99.4%). Moderate overall agreement was found among Alt-AKI, KDIGO, and pRIFLE definitions (κ = 0.18, 95% CI 0.1–0.27) in which KDIGO and pRIFLE showed moderate agreement (κ = 0.48, 95% CI 0.36–0.60). Conclusions: Compared to pRIFLE and KDIGO criteria, Alt-AKI criteria detected more patients with cisplatin nephrotoxicity. pRIFLE is more sensitive to detect not only actual kidney injury but also patients at risk of cisplatin nephrotoxicity, while KDIGO seems more useful to detect clinically significant kidney injury. A higher resolution version of the Graphical abstract is available as Supplementary information.
- Subjects
MEXICO; BRITISH Columbia; NEPHROTOXICOLOGY -- Risk factors; CONFIDENCE intervals; POPULATION geography; RETROSPECTIVE studies; ACQUISITION of data; PEDIATRICS; TUMORS in children; RISK assessment; COMPARATIVE studies; CISPLATIN; MEDICAL records; DESCRIPTIVE statistics; ACUTE kidney failure; LONGITUDINAL method; DISEASE risk factors
- Publication
Pediatric Nephrology, 2023, Vol 38, Issue 2, p593
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-022-05632-z