Zhi-Yu Duan1, Jie-Qiong Liu2, Pei Yin1, Ji-Jun Li3, Guang-Yan Cai4, Xiang-Mei Chen2. 1. Department of Nephrology, First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100048, China. 2. Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing 100853, China. 3. Department of Nephrology, First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100048, China. Electronic address: lijj9536@sina.com. 4. Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing 100853, China. Electronic address: caiguangyan@sina.com.
Abstract
BACKGROUND: Renal toxicity limits the clinical use of platinum-based therapy in the elderly. In order to clarify the impact of aging on the risk of platinum-related nephrotoxicity, the following meta-analysis was performed. METHODS: We searched multiple databases for studies published before January 2017. The inclusion criteria were case-control, cohort studies published in any language. RESULTS: The risk of platinum-induced nephrotoxicity in the older group was 1.43 times (risk rate) higher than in the non-older group. Platinum-induced nephrotoxicity in older patients was mainly I/II. There was no significant difference in the incidence of grade III/IV renal toxicity between groups. The risk for elderly patients in Asia was significantly higher than in Europe and North America. Carboplatin had a lower risk of renal toxicity and only half of the amount of moderate and severe nephrotoxicity than cisplatin. In the age stratification analysis, the RR values were 1.43, 1.51 and 1.35 respectively for the elderly group (55, 60, 70 years old), and all had significant differences. The risk of platinum-related nephrotoxicity in elderly patients was significantly increased in the high comorbidity rate group. Moreover, the RR values of the normal renal function group were significantly higher than that of the 'no mention or renal insufficiency' subgroup. CONCLUSIONS: Aging increased the risk of platinum-induced nephrotoxicity by 43%, partly due to more comorbidities in elderly patients, and mild renal toxicity was dominant. The risk of renal toxicity of the elderly patients in Asian countries was much higher than that of in European countries and North America.
BACKGROUND:Renal toxicity limits the clinical use of platinum-based therapy in the elderly. In order to clarify the impact of aging on the risk of platinum-related nephrotoxicity, the following meta-analysis was performed. METHODS: We searched multiple databases for studies published before January 2017. The inclusion criteria were case-control, cohort studies published in any language. RESULTS: The risk of platinum-induced nephrotoxicity in the older group was 1.43 times (risk rate) higher than in the non-older group. Platinum-induced nephrotoxicity in older patients was mainly I/II. There was no significant difference in the incidence of grade III/IV renal toxicity between groups. The risk for elderly patients in Asia was significantly higher than in Europe and North America. Carboplatin had a lower risk of renal toxicity and only half of the amount of moderate and severe nephrotoxicity than cisplatin. In the age stratification analysis, the RR values were 1.43, 1.51 and 1.35 respectively for the elderly group (55, 60, 70 years old), and all had significant differences. The risk of platinum-related nephrotoxicity in elderly patients was significantly increased in the high comorbidity rate group. Moreover, the RR values of the normal renal function group were significantly higher than that of the 'no mention or renal insufficiency' subgroup. CONCLUSIONS: Aging increased the risk of platinum-induced nephrotoxicity by 43%, partly due to more comorbidities in elderly patients, and mild renal toxicity was dominant. The risk of renal toxicity of the elderly patients in Asian countries was much higher than that of in European countries and North America.
Authors: Marije J Klumpers; Ward De Witte; Giovanna Gattuso; Elisabetta Schiavello; Monica Terenziani; Maura Massimino; Corrie E M Gidding; Sita H Vermeulen; Chantal M Driessen; Carla M Van Herpen; Esther Van Meerten; Henk-Jan Guchelaar; Marieke J H Coenen; D Maroeska W M Te Loo Journal: J Pers Med Date: 2022-05-28