Acute Kidney Injury Duration After Cisplatin Treatment and Subsequent CKD Risk: A Single-Center Retrospective Study

AKI commonly occurs after cisplatin treatment and is associated with long-term kidney dysfunction. Whether its duration is associated with subsequent CKD remains unclear.

This retrospective cohort study included adults treated with cisplatin from 2014 through 2023 who survived and remained under observation at a 90-day landmark after final administration. AKI was classified as transient (≤48 hours), persistent (>48 hours to 7 days), or acute kidney disease (>7 days). CKD incidence was estimated with death as a competing event, and associations were assessed using multivariable Fine-Gray models.

Among 1,643 patients reaching the landmark, 181 (11%) developed AKI and 408 (25%) developed CKD. At 1 year, CKD incidence was 20% without AKI, 22% with transient AKI, 46% with persistent AKI, and 46% with acute kidney disease. Compared with no AKI, adjusted subdistribution hazard ratios were 1.45 (95% confidence interval [CI], 0.70-3.03) for transient AKI, 2.66 (95% CI, 1.66-4.26) for persistent AKI, and 2.94 (95% CI, 1.72-5.03) for acute kidney disease. Additional adjustment for severity in exploratory analyses among patients with AKI did not materially attenuate the estimates, although CIs were wide.

AKI duration after cisplatin treatment was associated with subsequent CKD risk. Persistent AKI and acute kidney disease may identify higher-risk patients, but the prognostic value of duration beyond conventional severity staging requires external confirmation.