Innovative tool could safeguard cancer patients from chemotherapy-induced kidney damage

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Using diligent information from six awesome U.S. crab centers, Brigham researchers and collaborators developed a consequence prediction exemplary for moderate-to-severe kidney wounded aft receiving nan chemotherapy supplier cisplatin successful nan largest, first generalizable study of its kind.

Cisplatin is simply a highly effective chemotherapy that has been utilized to dainty crab for decades, but it tin origin kidney wounded that tin perchance lead to nan discontinuation of life-saving crab treatments. Investigators from Brigham and Women’s Hospital (BWH), a founding personnel of the Mass General Brigham healthcare system, pinch researchers from nan Dana-Farber Cancer Institute and different institutions, developed a broad instrumentality to foretell which patients are astatine highest consequence of moderate-to-severe kidney wounded aft cisplatin. They recovered that nan highest-risk patients had arsenic overmuch arsenic a 20-fold higher consequence of processing kidney wounded aft cisplatin than those successful nan lowest-risk group. Their results are published in The BMJ.

“Patients receiving curen for crab are progressively affected by kidney injury, which is associated pinch higher mortality and tin jeopardize eligibility for different therapies,” said first author Shruti Gupta, MD, MPH, director of Onco-nephrology astatine BWH and Dana-Farber and a expert successful BWH’s Division of Renal Medicine. 

Cisplatin is simply a well-known kidney toxin, and moreover though location are newer treatments available, it remains a cornerstone of therapy for patients pinch crab globally. This large, multicenter collaboration and resulting consequence prediction exemplary is an important measurement successful nan attraction of patients who are getting cisplatin.”

Shruti Gupta, MD, MPH, Director of Onco-nephrology, BWH

The researchers examined information from complete 24,000 patients crossed six awesome U.S. crab centers, including Dana-Farber Brigham Cancer Center, Mass General Cancer Center, Memorial Sloan Kettering Cancer Center, MD Anderson Cancer Center, University of Colorado, and Northwell Health, and analyzed nan consequence of moderate-to-severe acute kidney wounded wrong nan first 14 days pursuing a single, first IV dose of cisplatin. The exemplary developed by nan investigation squad included respective important consequence factors for kidney wounded including age, precocious humor pressure, diabetes, laboratory findings from routinely disposable bloodwork, and higher doses of cisplatin. They recovered that patients who developed kidney wounded from cisplatin had a considerably higher consequence of decease compared to those who did not.

Another cardinal uncovering was that little levels of magnesium were an important consequence facet for acute kidney injury. The researchers scheme to usage nan aforesaid rich | database to effort to place therapies that mightiness forestall kidney injury, including magnesium.

Using nan consequence score, nan investigation squad created a elemental online calculator that will beryllium made disposable for usage at MDCalc.com. A diligent aliases expert tin usage this calculator to quantify nan consequence of kidney wounded by inputting information, including whether nan diligent has precocious humor pressure, diabetes, aliases different diseases aliases aesculapian conditions, on pinch results from their bloodwork.

“This caller instrumentality tin thief an oncologist and a diligent person much informed conversations astir nan risks and benefits of cisplatin. If a diligent is astatine precocious risk, their objective squad tin see preventative measures specified arsenic administering much IV fluids earlier receiving cisplatin aliases monitoring their kidney usability much intimately afterward,” said elder author David E. Leaf, MD, MMSc, director of objective and translational investigation successful acute kidney wounded astatine BWH’s Division of Renal Medicine. “The objective characteristics and laboratory values that are incorporated successful our exemplary are readily disposable and easy obtainable from aesculapian records, truthful our dream is that this instrumentality tin beryllium implemented anyplace cisplatin is given.”

Source:

Journal reference:

Gupta, S., et al. (2024). Derivation and outer validation of a elemental consequence people for predicting terrible acute kidney wounded aft intravenous cisplatin: cohort study. BMJ. doi.org/10.1136/bmj-2023-077169.