Prediction of nephrotoxicity induced by cisplatin combination chemotherapy in gastric cancer patients

Table 1 Characteristics of 41 patients who developed nephrotoxicity induced by cisplatin combination chemotherapy

Gender	M	36
	F	5
Age	58.36 ± 10.54
BSA1	1.677 ± 0.141
Operation	None	3
	RSG c BI	15
	RSG c BII	5
	RSG c R-Y	7
	RTG c R-Y	5
	Pal2	6
Stage	IA	1
	IB	5
	II	5
	IIIA	9
	IIIB	2
	IV	19
Combination drug	5-FU3	18
	Docetaxel	10
	5-FU3 + MMC4	5
	Paclitaxel	3
	TS-1	2
	Irinotecan	2
	Capecitabine	1

¹Body surface area;

²Palliative operation including gastrojejuno bypass, open and closure;

³5-flourouracil;

⁴Mitomycin.

Table 2 Pre-acute renal failure (ARF) laboratory data¹ corresponding to renal status post-ARF²

			Renal status of post-ARF		P value3
Variable	Normal range	Unit	Recovered (n = 33)	Unrecovered (n = 8)
Hb	14.0–16.7	g/dL	10.33 ± 1.28 (n = 33)	9.75 ± 0.95 (n = 8)	0.238
HT	14.7–50.7	%	29.88 ± 3.33 (n = 33)	28.56 ± 2.78 (n = 8)	0.307
Protein	6.3–8.3	g/dL	6.792 ± 0.69 (n = 26)	6.429 ± 0.39 (n = 7)	0.191
Albumin	3.5–5.0	g/dL	3.97 ± 0.54 (n = 26)	3.87 ± 0.38 (n = 7)	0.657
BUN	5–23	mg/dL	18.07 ± 5.35 (n = 33)	15.63 ± 4.03 (n = 8)	0.236
SCR	0.3-1.5	mg/dL	1.17 ± 0.20 (n = 33)	1.38 ± 0.13 (n = 8)	0.008
GFR	120-130	mL/min	68.03 ± 13.31 (n = 33)	59.13 ± 6.64 (n = 8)	0.076
Na	136–150	meg/L	139.24 ± 3.19 (n = 33)	140.13 ± 4.09 (n = 8)	0.510
Cl	98–110	meg/L	105.31 ± 4.42 (n = 24)	105.57 ± 3.65 (n = 7)	0.887
K	3.5–5.3	meg/L	4.49 ± 0.46 (n = 8)	4.66 ± 0.65 (n = 8)	0.284
P	3.0–4.5	mg/dL	3.97 ± 0.81 (n = 20)	3.93 ± 1.16 (n = 6)	0.940
Mg	1.6–2.6	mg/dL	2.08 ± 0.26 (n = 24)	2.03 ± 0.29 (n = 7 )	0.635
Ca	8.0-10.0	mg/dL	9.15 ± 0.53 (n = 24)	8.86 ± 0.30 (n = 7)	0.170

¹Pre-acute renal failure (ARF) Laboratory data were checked immediately before the administration of the chemotherapy drug that caused the serum creatinine (SCR) to increase to > 1.5 mg/dL. ²We divided 41 patients into two groups; the recovered group included patients whose SCRs had decreased below 1.5 mg/dL after ARF, the unrecovered group included patients whose SCRs remained greater than 1.5 mg/dL.

³Unpaired Student’s t–test. BUN: Blood urea nitrogen; GFR: Glomerular filtration rate.

Table 3 Acute renal failure (ARF) laboratory data¹ corresponding to renal status post-ARF²

			Renal status post-ARF		P value3
Variable	Normal range	Unit	Recovered (n = 33)	Unrecovered (n = 8)
Hb	14.0–16.7	g/dL	10.28 ± 1.62 (n = 31)	10.238 ± 1.30 (n = 8)	0.941
HT	14.7–50.7	%	29.52 ± 4.70 (n = 32)	29.93 ± 3.41 (n = 8)	0.820
Protein	6.3–8.3	g/dL	6.72 ± 0.78 (n = 24)	7.00 ± 0.95 (n = 3)	0.564
Albumin	3.5–5.0	g/dL	3.95 ± 0.61 (n = 24)	4.03 ± 0.65 (n = 3)	0.818
BUN	5–23	mg/dL	23.78 ± 13.60 (n = 33)	23.0 ± 4.87 (n = 8)	0.876
SCR	0.3-1.5	mg/dL	1.75 ± 0.48 (n = 33)	2.21 ± 0.61 (n = 8)	0.026
GFR	120-130	mL/min	43.30 ± 7.81 (n = 33)	36.0 ± 8.98 (n = 8)	0.026
Na	136–150	meg/L	136.60 ± 4.36 (n = 32)	137.63 ± 2.72 (n = 8)	0.529
Cl	98–110	meg/L	101.49 ± 6.59 (n = 24)	99.50 ± 2.65 (n = 4)	0.564
K	3.5–5.3	meg/L	4.22 ± 0.93 (n = 32)	4.46 ± 0.60 (n = 8)	0.491
P	3.0–4.5	mg/dL	4.13 ± 0.87 (n = 18)	3.93 ± 0.43 (n = 4)	0.659
Mg	1.6–2.6	mg/dL	1.83 ± 0.42 (n = 22)	1.833 ± 0.47 (n = 3)	0.995
Ca	8.0-10.0	mg/dL	9.06 ± 0.51 (n = 23)	9.40 ± 0.80 (n = 4)	0.269

¹Laboratory data were checked at the time at which the value of serum creatinine (SCR) was highest after increasing the SCR > 1.5 mg/dL. ²We divided 41 patients into two groups; recovered consisted of patients whose SCRs had decreased below 1.5 mg/dL after acute renal failure, unrecovered consisted of patients whose SCRs remained greater than 1.5 mg/dL.

³Unpaired Student’s t–test. BUN: Blood urea nitrogen; GFR: Glomerular filtration rate.

Table 4 Comparison between the cycle during which nephrotoxicity occurred and the amount of accumulated cisplatin according to renal status post-acute renal failure (ARF)

	Renal status post-ARF		P value3
	Recovered1 (n = 33)	Unrecovered2 (n = 8)
The cycle nephrotoxicity occurred	4.24 ± 2.09	6.63 ± 2.62	0.009
The cumulative dose of cisplatin/BSA, mg	302.85 ± 152.73	497.75 ± 222.61	0.005

¹Recovered were patients whose serum creatinine (SCR)s had decreased below 1.5 mg/dL after acute renal failure.

²Unrecovered were patients whose SCRs remained greater than 1.5 mg/dL.

³Unpaired Student’s t–test. ARF: Acute renal failure; BSA: Body surface area.

Table 5 Subsequent renal status corresponding to subsequent treatment in the recovered group

		Subsequent renal status				P value4
		Normal1	Recovered2	Unrecovered3	Total
Subsequent treatment	Stop	5	2	0	7
	Reduce	2	4	0	6
	Continue	5	8	7	20
	Total	12	14	7	33
						0.011

¹Normal were patients whose serum creatinine (SCR)s had not increased greater than 1.5 mg/dL after subsequent treatment.

²Recovered were patients whose SCRs had decreased below 1.5 mg/dL after acute renal failure.

³Unrecovered were patients whose SCRs remained greater than 1.5 mg/dL.

⁴Linear by linear association.

Table 6 Subsequent renal status corresponding to subsequent treatment in the unrecovered group

		Subsequent renal status				P value4
		Normal1	Recovered2	Unrecovered3	Total
Subsequent treatment	Stop	0	2	2	4
	Reduce	0	0	3	3
	Continue	0	0	1	1
	Total	0	2	6	8
						0.170

¹Normal were patients whose serum creatinine (SCR)s had not increased greater than 1.5 mg/dL after subsequent treatment.

²Recovered were patients whose SCRs had decreased below 1.5 mg/dL after acute renal failure.

³Unrecovered were patients whose SCRs remained greater than 1.5 mg/dL.

⁴Linear by linear association.