Results

Mean follow-up was 6 years (25th and 75th percentiles, 4 and 9 years). AKI occurred in 31.5% of patients, with a median initial decline in eGFR of 10 ml/min per 1.73 m 2 (25th and 75th percentiles,− 41.5 and− 23.3 ml/min per 1.73 m 2). At any time point after the first cycle of cisplatin,< 3% of patients progressed to eGFR< 29 ml/min per 1.73 m 2, and none were known to be on dialysis. Age was associated with a higher risk for AKI after cisplatin. Compared with age< 25 years old, the odds ratios for AKI versus no AKI are 1.22 for> 26–44 years old (95% confidence interval [95% CI], 0.60 to 2.4), 1.54 for> 45–65 years old (95% CI, 0.78 to 3), and 2.96 for> 66 years old (95% CI, 1.4 to 6.1). The lowest dose categories of cisplatin (≤ 100 and 101–250 mg/m 2) are associated with increases in eGFR (P= 0.06 and P= 0.02, respectively) compared with the highest dose category (> 701 mg/m 2).

Conclusions

This is the largest study of adult patients with cancer who received cisplatin for treatment across multiple tumor types. Most patients experience small but permanent declines in eGFR, but none progressed to ESRD requiring hemodialysis.