(B-020) Incidence and Risk Factors of chemotherapy-induced Nephrotoxicity in Cancer Patients with Proper Hydration and Dose Adjustments: A Prospective Hospital-based Study

Background: Chemotherapy-induced nephrotoxicity is a major concern that affects cancer patients and leads to treatment delay, regimen modification, or discontinuation.

Objectives: To determine the incidence and risk factors for nephrotoxicity in cancer patients who underwent chemotherapy with hydration protocol and dose adjustments.

Methods: This is an ongoing, prospective cohort cancer study, conducted in a public teaching hospital at the Radiation Oncology Department in the region of North India. The study included patients aged above 18 years, provided informed consent, and had baseline eGFR >60 ml/min/1.73 m2. Patient demographic details, diagnosis, treatment, and laboratory parameters like renal functions were assessed at baseline and before each chemotherapy cycle. The KDIGO guideline was used to assess AKI. Two groups, (1) Cisplatin mono or combine therapy and (2) Non-cisplatin therapy (Adriamycin, cyclophosphamide, bleomycin, vinblastine, paclitaxel). With the cisplatin group, hydrated with normal saline 1.5 -2 lt, Ringer lactate 100 ml and 20% of 100 ml of mannitol with KCL (20 mEq), 2 ml of MGSO4 (1 g) were given. Descriptive statistics, chi-square test, and odds ratio at 95% CI were used to analyse the data (IBM SPSS v25).

Results: A total of 78 cancer patients with average age of 57.65±12.2yrs were included. 58% of patients were exposed to cisplatin. Forty-six patients are freshly diagnosed with cancer. The most common malignancies were breast cancer (n = 15, 19.2%), cervical cancer (n = 9, 11.5%), and oral cavity cancers (n = 7, 9.0%). 25 (32%) patients suffer from hypertension, and 10 (12%) patients suffer from diabetes mellitus.
The overall incidence of nephrotoxicity (Grade 1 AKI) was found to be 21.8% (17/78 patients). The cisplatin group was found to be higher (16.6% vs. 5.1%) non -cisplatin group. Risk factor analysis showed a significant association between cisplatin agents and nephrotoxicity (OR = 3.830, CI 95% (1.12 – 13.0), p = 0.026), no statistically significant association between age, diabetes, or diagnosed status but with gender (male; OR = 0.549), and hypertension (OR = 1.206) had a trend toward increased nephrotoxicity risk.

Conclusions: These early findings indicate that the overall incidence was 21.8%, with a risk factor showing a significant association between the cisplatin group and nephrotoxicity. Hydration and dose adjustment may reduce nephrotoxicity risk.