Oral hydration does not increase the risk of nephrotoxicity and is safe for patients with lung cancer treated with cisplatin, according to a study published in Supportive Care in Cancer

Cisplatin is a frequently used anticancer medication in the treatment of various cancers and is associated with various adverse events, such as nephrotoxicity. Intravenous (IV) active hydration, pre- and postchemotherapy, is the most commonly used intervention to prevent nephrotoxicity, but evidence suggesting that oral hydration is as effective and more feasible than IV administration led to changes in practice. 

For this single-center retrospective study, researchers assessed the outcomes of 517 patients with lung cancer to determine the incidence of cisplatin-induced nephrotoxicity. In all, 241 patients received IV hydration before and after cisplatin (IV/IV) and 276 patients received IV then oral hydration (IV/PO).

Results showed that nephrotoxicity occurred significantly more often in the IV/IV arm; 39.4% of patients in the IV/IV group experienced grade 1 or higher nephrotoxicity compared with 25.7% of patients in the IV/PO group (P=.001). Grade 2 or higher nephrotoxicity occurred in 3.7% of the IV/IV group vs 1.8% in the IV/PO group, but this improvement was not found to be significant (P=.27). 

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A multivariate analysis showed that advanced age (older than 70) was predictive for nephrotoxicity, and the IV/PO regimen significantly reduced nephrotoxic risk. 

The authors concluded that “our observation based on large data from clinical practice shows that oral hydration after cisplatin is safe.”

Reference

Puisset F, Bigay-Game L, Paludetto MN, et al. Safety of oral hydration after cisplatin infusion in an outpatient lung cancer unit[published online August 17, 2018]. Support Care Cancer. doi: 10.1007/s00520-018-4415-7