Abstract 1373P
Background
Nephrotoxicity is a frequently occurring side effect of cisplatin which may be reduced by applying ample hydration. The aim of this study was to determine whether there is a difference in nephrotoxicity due to cisplatin between a short hydration (SH) and long hydration scheme (LH).
Methods
A retrospective, observational, cohort study was conducted among patients from two hospitals with either a short or a long hydration scheme. All other aspects of treatment and hydration were comparable. Patients (≥18 years) treated for non-small cell lung cancer with cisplatin-pemetrexed with ≥1 cisplatin dose were included. Patients were excluded when serum creatinine at baseline was <40 μmol/L. Primary outcome was the difference in estimated glomerular filtration rate (eGFR) between baseline and after the last cisplatin infusion for the SH and LH patients, regardless of the number of administered cisplatin courses.
Results
Fifty patients were included in each group. There were no significant differences in baseline characteristics between the two groups and none of the patients had renal failure at baseline. After two cisplatin cycles, the median differences between the baseline eGFR and the eGFR after the last cisplatin dose were 1 (-6 – 5) and -9 (-22 – -2) ml/min/1,73m2 (interquartile range) for the SH and LH, respectively (P=0.000). Less patients completed the four cycles in the LH group compared to the SH group mainly due to nephrotoxicity and switching to another treatment. However, the difference in eGFR remained statistically significant (P=0.027).
Conclusions
In this population, the SH scheme resulted in less nephrotoxicity compared to the LH scheme, with a significant and clinically relevant difference. More LH patients stopped this effective treatment prematurely due to nephrotoxicity. In conclusion, short hydration was more effective in prevention of nephrotoxicity and also reduces patient burden and hospital occupancy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.