Prevention of Cisplatin-Induced Acute Kidney Injury: A Systematic Review and Meta-Analysis

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#acute-kidney-injury #cisplatin #drug-related-side-effects-and-adverse-reactions #humans #observational-studies-as-topic

Prevention of Cisplatin-Induced Acute Kidney Injury: A Systematic Review and Meta-Analysis

Hamroun et al., 2019 | Drugs | Meta Analysis

Citation

Hamroun Aghilès, Lenain Rémi, ... Glowacki François. Prevention of Cisplatin-Induced Acute Kidney Injury: A Systematic Review and Meta-Analysis. Drugs. 2019-Sep;79(14):1567-1582. doi:10.1007/s40265-019-01182-1

Abstract

PURPOSE: Cisplatin-induced acute kidney injury (CIA) is a serious adverse event that affects 20-40% of exposed patients, despite any implemented precaution to avoid it. The aim of this work was therefore to identify a relevant nephroprotective method for CIA. METHODS: We searched Pubmed, Embase, and Web of Science from 1 January 1978 to 1 June 2018, without language restriction. All studies (observational and interventional) assessing a CIA prevention method for adults receiving at least one course of cisplatin were eligible. The primary outcome was acute nephrotoxicity, as defined by the AKI-KDIGO classification (2012). The odds ratio and corresponding 95% confidence interval were used to assess the associations. We used narrative synthesis in case of heterogeneity regarding intervention, population, or outcome. When possible, a random-effects model was used to pool studies. The heterogeneity between studies was quantified (I2), and multiple meta-regressions were carried out to identify potential confounders. RESULTS: Within 4520 eligible studies, 51 articles fulfilling the selection criteria were included in the review, assessing 21 different prevention methods. A meta-analysis could only be performed on the 15 observational studies concerning magnesium supplementation (1841 patients), and showed a significant nephroprotective effect for all combined grades of CIA (OR 0.24, [0.19-0.32], I2 = 0.0%). This significant nephroprotective effect was also observed for grades 2 and 3 CIA (OR 0.22, [0.14-0.33], I2 = 0.0% and OR 0.25, [0.08-0.76], I2 = 0.0%, respectively). CONCLUSION: While no method of prevention had so far demonstrated its indisputable efficacy, our results highlight the potential protective effect of magnesium supplementation on cisplatin-induced acute nephrotoxicity. TRIAL REGISTRATION: This study is registered in PROSPERO, CRD42018090612.

Key Findings

Within 4520 eligible studies, 51 articles fulfilling the selection criteria were included in the review, assessing 21 different prevention methods. A meta-analysis could only be performed on the 15 observational studies concerning magnesium supplementation (1841 patients), and showed a significant nephroprotective effect for all combined grades of CIA (OR 0.24, [0.19-0.32], I2 = 0.0%). This significant nephroprotective effect was also observed for grades 2 and 3 CIA (OR 0.22, [0.14-0.33], I2 = 0

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 1841
Age Range See abstract
Condition See abstract

MeSH Terms

  • Acute Kidney Injury
  • Cisplatin
  • Drug-Related Side Effects and Adverse Reactions
  • Humans
  • Observational Studies as Topic

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: magnesium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09