Hydration practices during cisplatin administration: a national multicenter survey

Area of Science:

• Oncology
• Nephrology
• Clinical Pharmacy

Background:

• Cisplatin is a vital chemotherapy agent, but its use is limited by nephrotoxicity.
• Current hydration protocols to prevent cisplatin-induced kidney damage lack international consensus.
• Short hydration regimens show promise for nephroprotection and improved patient quality of life.

Purpose of the Study:

• To survey French oncology professionals regarding their current cisplatin hydration practices.
• To identify variations in hydration protocols, electrolyte supplementation, and renal function monitoring.
• To compare current practices with emerging evidence on short hydration regimens.

Main Methods:

• A national, multicenter survey of 173 French oncology professionals was conducted online.
• The survey assessed demographics, hydration protocols (long vs. short), diuretic use, and renal function monitoring methods.
• Data were analyzed using descriptive statistics and appropriate statistical tests.

Main Results:

• Significant heterogeneity in hydration practices was observed, with 73% using long (>24h) and 16% using short (≤4.5h) regimens.
• Most respondents used CKD-EPI (52%) or MDRD (42%) for renal function assessment.
• A creatinine clearance threshold of 60 mL/min was commonly used to contraindicate cisplatin (72%).
• Hospital-based hydration was prevalent in public institutions, while private centers favored home-based strategies.
• Routine magnesium (57%) and potassium (37%) supplementation was common.

Conclusions:

• French cisplatin hydration practices are highly heterogeneous, differing from international trends towards short outpatient regimens.
• There is a clear need for updated, evidence-based national and international guidelines.
• Harmonizing practices will optimize nephroprotection and support the expansion of outpatient and home hydration models.