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Antihypertensive Drug Combinations Modify Cisplatin-induced Acute Kidney Injury

Koji Takeuchi1, Rintaro Sogawa1, Satoko Tsuruhashi1

  • 1Department of Pharmacy, Saga University Hospital, Saga, Japan.

In Vivo (Athens, Greece)
|April 28, 2022
PubMed
Abstract

Insights

Concomitant use of calcium channel blockers (CCBs) and renin-angiotensin system (RAS) inhibitors with cisplatin (CDDP) significantly increases the risk of acute kidney injury (AKI). Healthcare providers should monitor patients closely for AKI when these drug combinations are prescribed.

Area of Science:

  • Nephrology
  • Pharmacology
  • Oncology

Background:

  • Limited evidence exists on the nephrotoxicity of combined calcium channel blockers (CCBs) and renin-angiotensin system (RAS) inhibitors with cisplatin (CDDP).
  • Acute kidney injury (AKI) is a potential adverse effect of CDDP treatment.

Purpose of the Study:

  • To investigate the association between antihypertensive drug combinations and CDDP-related AKI.
  • To evaluate the risk of AKI when CCBs and RAS inhibitors are used concurrently with CDDP.

Main Methods:

  • Analysis of 544,864 reports from the Japanese Adverse Drug Event Report database (2004-2020).
  • Calculation of reporting odds ratios (ROR) and confidence intervals (CI) for AKI, adjusting for confounding factors.
  • Assessment of individual drug use and combined use with CDDP.

Main Results:

  • CDDP, CCBs, and RAS inhibitors were all identified as risk factors for AKI.
  • Concomitant use of CCBs, RAS inhibitors, and CDDP showed a significantly higher ROR for AKI (adjusted ROR 7.28; 95% CI=5.56-9.54) compared to individual drug use.
  • The combined drug regimen presented a notable signal for AKI.

Conclusions:

  • Concomitant use of CCBs and RAS inhibitors with CDDP is associated with an increased risk of AKI.
  • Increased vigilance for AKI is warranted in patients receiving CDDP who are also taking CCBs and RAS inhibitors.
  • This finding highlights the importance of careful medication management in cancer patients undergoing chemotherapy.
Keywords:
Cisplatinacute kidney injuryantihypertensive drug

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