内容紹介
Associations between Clinical Factors and Acute Renal Failure Due to Cisplatin Combination Chemotherapy for Lung Cancer
Summary
In this study, we investigated the clinical factors associated with acute kidney injury(AKI)due to combination therapy with cisplatin(CDDP)for treating lung cancer. We classified cases according to the presence or absence of adequate hydration and magnesium(Mg)administered above the regulations of the registered regimen to evaluate the effect due to differences in hydration on AKI. We also investigated clinical factors before and after administration of CDDP in each case group, and examined their association with AKI. Seventy-four patients with lung cancer that were indicated for treatment with a CDDP combination regimen between December 2012 and April 2013 were studied. The patients whose conditions progressed to AKI of ≥grade 2 accounted for 0%(0/33)in the Mg administration group and 7.3%(3/41)in the Mg non-administration group. In particular, 2 cases of serious AKI(grade 4)were observed in the Mg non-administration without additional hydration group. When compared with other groups, a high antiemetic rate and favorable urine volume were observed in the Mg administration with additional hydration group. In the patients with AKI, many developed hyponatremia of ≥grade 3 within 1 week after administration of CDDP. Although Mg administration and ample hydration seem to be effective measures to deal with CDDP-caused AKI, comprehensive monitoring, including antiemesis therapy, after CDDP administration and correction of electrolytes is important.
要旨
肺癌に対してのシスプラチン(CDDP)併用化学療法適用症例(74例: 2012年12月～2013年4月)を対象として,hydration法の違い[規定外の追加hydrationおよびマグネシウム(Mg)投与の有無]で症例を分類し,CDDP投与後の急性腎不全(acute kidney injury: AKI)と他の有害事象の発生状況を後方視的に調査し,関連性について検討した。grade 2以上のAKIを来した症例はMg投与群0%(0/計33例),非投与群7.3%(3/計41例)であり,Mg非投与/追加hydrationなし症例群でgrade 4に至る重篤なAKIを2例認めた。Mg投与/追加hydrationあり群で高い制吐率と良好な尿量確保を得た。AKI症例では,CDDP投与後1週間以内にgrade 3以上の低ナトリウム(Na)血症を来す症例が多かった。CDDP由来のAKI対策では,Mg投与と十分なhydrationの他,制吐達成や電解質補正を含めた対応が重要である。
目次
Summary
In this study, we investigated the clinical factors associated with acute kidney injury(AKI)due to combination therapy with cisplatin(CDDP)for treating lung cancer. We classified cases according to the presence or absence of adequate hydration and magnesium(Mg)administered above the regulations of the registered regimen to evaluate the effect due to differences in hydration on AKI. We also investigated clinical factors before and after administration of CDDP in each case group, and examined their association with AKI. Seventy-four patients with lung cancer that were indicated for treatment with a CDDP combination regimen between December 2012 and April 2013 were studied. The patients whose conditions progressed to AKI of ≥grade 2 accounted for 0%(0/33)in the Mg administration group and 7.3%(3/41)in the Mg non-administration group. In particular, 2 cases of serious AKI(grade 4)were observed in the Mg non-administration without additional hydration group. When compared with other groups, a high antiemetic rate and favorable urine volume were observed in the Mg administration with additional hydration group. In the patients with AKI, many developed hyponatremia of ≥grade 3 within 1 week after administration of CDDP. Although Mg administration and ample hydration seem to be effective measures to deal with CDDP-caused AKI, comprehensive monitoring, including antiemesis therapy, after CDDP administration and correction of electrolytes is important.
要旨
肺癌に対してのシスプラチン(CDDP)併用化学療法適用症例(74例: 2012年12月～2013年4月)を対象として,hydration法の違い[規定外の追加hydrationおよびマグネシウム(Mg)投与の有無]で症例を分類し,CDDP投与後の急性腎不全(acute kidney injury: AKI)と他の有害事象の発生状況を後方視的に調査し,関連性について検討した。grade 2以上のAKIを来した症例はMg投与群0%(0/計33例),非投与群7.3%(3/計41例)であり,Mg非投与/追加hydrationなし症例群でgrade 4に至る重篤なAKIを2例認めた。Mg投与/追加hydrationあり群で高い制吐率と良好な尿量確保を得た。AKI症例では,CDDP投与後1週間以内にgrade 3以上の低ナトリウム(Na)血症を来す症例が多かった。CDDP由来のAKI対策では,Mg投与と十分なhydrationの他,制吐達成や電解質補正を含めた対応が重要である。