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 888
OP 894
DO 10.1183/09031936.00055110
VO 37
IS 4
A1 C. Máthé
A1 A. Bohács
A1 L. Duffek
A1 J. Lukácsovits
A1 Z.I. Komlosi
A1 K. Szondy
A1 I. Horváth
A1 V. Müller
A1 G. Losonczy
YR 2011
UL http://erj.ersjournals.com/content/37/4/888.abstract
AB Ageing lung cancer patients may be at increased risk of Cisplatin (Cp) nephrotoxicity, because of comorbidities leading to accelerated ageing of the kidneys. Therefore, the Cp-induced impairement of renal function was compared between no comorbidity (NC) and hypertension plus ischaemic heart disease (CD) patients or others having diabetes mellitus plus ischaemic heart disease (DMIH).In a preliminary study, glomerular filtration rate (GFR) was measured by clearance of technetium 99m-labelled diethylene-thiamine penta-acetate 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 using calculated creatinine clearance.Pre-treatment GFR was 57±3 mL·min−1·m−2 in those with normal (n = 15) and 42±2 mL·min−1·m−2 in those with pathologically increased (n = 23) [creat] any time following their 2nd–4th Cp cycle (p<0.05). The retrospective analysis revealed that Cp-induced nephrotoxicity developed in 7.5% of the NC (n = 80), in 20.9% of the CD (n = 110) and in 30.8% of the DMIH (n = 52) subgroups. Within the overall dropout rate from further Cp chemotherapy, nephrotoxicity was responsible in 14% of NC, 38% in CD and 75% in DMIH patients.A major portion of our ageing lung cancer patients suffered from comorbidities leading to reduced renal resistance to Cp nephrotoxicity.