RT Journal Article
SR Electronic
T1 Cisplatin nephrotoxicity aggravated by cardiovascular disease and diabetes in lung cancer patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj00551-2010
DO 10.1183/09031936.00055110
A1 Cs. Máthé
A1 A. Bohács
A1 L. Duffek
A1 J. Lukácsovits
A1 Z.I. Komlosi
A1 K. Szondy
A1 I. Horváth
A1 V. Müller
A1 Gy. Losonczy
YR 2010
UL http://erj.ersjournals.com/content/early/2010/07/22/09031936.00055110.abstract
AB Aging lung cancer patients may be at increased risk of Cisplatin (Cp) nephrotoxicity, because of comorbidities leading to accelerated aging of the kidneys. Therefore the Cp-induced impairement of renal function was compared between no comorbidity (NC) and hypertension+ ischemic heart disease (CD) patients or others having diabetes mellitus+ ischemic heart disease (DMIH).In a preliminary study GFR was measured by clearance of 99mTc-DTPA in 38 lung cancer patients with normal serum creatinine concentration ([creat]). Then, the incidence of nephrotoxicity was analysed retrospectively over 1st-4th cycles of Cp treatment among 242 lung cancer patients with initially normal [creat]. GFR was repeatedly estimated by calculated creatinine clearance (eGFR).Pre-treatment GFR was 57±3 mL·min−1·m−2 in those with normal (n=15) and 42±2 (p<0.05) in others with pathologically increased (n=23) [creat] any time following their 2nd-4th Cp cycle. The retrospective analysis revealed that Cp-induced nephrotoxicity developed in 7.5% of NC (n=80), in 20.9% of CD (n=110) and in 30.8% of DMIH (n=52) subgroups. Within overall fall-out from further Cp chemotherapy, nephrotoxicity was responsible in 14% of NC, 38% in CD and 75% in DMIH patients.A major portion of our aging lung cancer patients suffered from comorbidities leading to reduced renal resistance to Cp nephrotoxicity.