Short Hydration Regimen in Cisplatin-Based Chemotherapy and Its Impact on Nephrotoxicity: A Unicentric Prospective Study

Abstract

Nephrotoxicity is common when cisplatin is used and hydration during treatment is nephroprotective, but the optimal volume, composition, and duration are unknown. We reviewed our institutional intravenous hydration regimen (total 2500 mL in 5 hours versus previously used 3000 mL in 7 hours) in cisplatin >50 mg/m 2 schemes and we aimed to confirm the safety of this change by prospectively evaluating the incidence of acute kidney injury (AKI). We included 105 patients in our cohort. However, for comparison, we only considered 96 cases and 191 controls (ratio 2:1), due to the impossibility of matching all cases. The proportion of patients without Kidney Disease Improving Global Outcomes (KDIGO) AKI stage ≥2 (serum creatinine ≥2.0-2.9 times baseline) was 100.0% (n=96) after the first treatment and 97.8% (n=88) after the second treatment in our cohort. There was no difference when compared with the historical cohort of patients who received the previous cisplatin hydration regimen (p=1 for the first treatment and p=0.92 for the second treatment). AKI was the reason for cisplatin discontinuation in three patients (2.9%). Our results support the safety of a shorter and lower volume intravenous hydration during cisplatin treatment, which is more comfortable for patients and allows a better health resource allocation.