A Systematic Review of Strategies to Prevent Cisplatin-Induced Nephrotoxicity
Crona DJ, Faso A, Nishijima TF, McGraw KA, Galsky MD, Milowsky MI
The oncologist · 305 citas
Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institute of General Medical Sciences
- Gobierno
- NIGMS NIH HHS
- Subvenciones
- National Institute of General Medical Sciences (T32-GM086330)
Según 2 financiadores declarados.
Publicación
- Publicado
- 2017-04-24 · Oncologist · vol. 22 · número 5 · págs. 609–619
- Editorial
- AlphaMed Press
- Citado
- 404 citas · más que el 98% de estudios similares · 5.7× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 54 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Chemotherapy-induced organ toxicity mitigation · Chemotherapy-induced cardiotoxicity and mitigation · Cancer Treatment and Pharmacology
- Palabras clave
- Medicine, Nephrotoxicity, Cisplatin, Diuresis, Pharmacology, Intensive care medicine, Urology, Toxicity, Internal medicine, Chemotherapy, Renal function
- MeSH
- kidney, humans, neoplasms, cisplatin, antineoplastic agents, evidence-based medicine, dose-response relationship, drug, female, male, drug-related side effects and adverse reactions
6 autores
- Daniel James Crona🇺🇸University of North Carolina at Chapel Hill; University of North Carolina Hospitals; UNC Lineberger Comprehensive Cancer Center
- Aimee Faso🇺🇸University of North Carolina Hospitals
- Tomohiro F. Nishijima🇺🇸University of North Carolina at Chapel Hill
- Kathleen A. McGraw🇺🇸University of North Carolina at Chapel Hill
- Matthew D. Galsky🇺🇸Icahn School of Medicine at Mount Sinai
- Matthew I. Milowsky🇺🇸 · autor de correspondenciaUniversity of North Carolina at Chapel Hill; UNC Lineberger Comprehensive Cancer Center
Resumen
El texto original del estudio, en el idioma en que se publicó.
Introduction
Cisplatin, a platinum-based antineoplastic agent, is the cornerstone for the treatment of many malignancies. Nephrotoxicity is the primary dose-limiting toxicity, and various hydration regimens and supplementation strategies are used to prevent cisplatin-induced kidney injury. However, evidence-based recommendations on specific hydration regimens are limited. A systematic review was performed to evaluate clinical studies that have examined hydration and supplementation strategies to prevent cisplatin-induced nephrotoxicity.
Materials and methods
PubMed and Excerpta Medica databases were searched from 1966 through October 2015 for clinical trials and other studies focused on hydration regimens to prevent nephrotoxicity in cancer patients treated with cisplatin. The University of Oxford Centre for Evidence-Based Medicine criteria were used to grade level of evidence.
Results
Among the 1,407 identified studies, 24 were included in this systematic review. All studies differed on type, volume, and duration of hydration. Among the 24 studies, 5 evaluated short-duration hydration, 4 evaluated low-volume hydration, 4 investigated magnesium supplementation, and 7 reviewed forced diuresis with hydration. Short-duration and lower-volume hydration regimens are effective in preventing cisplatin-induced nephrotoxicity. Magnesium supplementation may have a role as a nephroprotectant, and forced diuresis may be appropriate in some patients receiving cisplatin.
Conclusion
Hydration is essential for all patients to prevent cisplatin-induced nephrotoxicity. Specifically, short-duration, low-volume, outpatient hydration with magnesium supplementation and mannitol forced diuresis (in select patients) represent best practice principles for the safe use of cisplatin. The Oncologist 2017;22:609-619 IMPLICATIONS FOR PRACTICE: The findings contained within this systematic review show that (a) hydration is essential for all patients to prevent cisplatin-induced nephrotoxicity, (b) short-duration, low-volume, outpatient hydration regimens appear to be safe and feasible, even in patients receiving intermediate- to high-dose cisplatin, (c) magnesium supplementation (8-16 milliequivalents) may limit cisplatin-induced nephrotoxicity, and (d) mannitol may be considered for high-dose cisplatin and/or patients with preexisting hypertension. These findings have broad implications for clinical practice and represent best practice principles for the prevention of cisplatin-induced nephrotoxicity.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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