META-ANALYSIS OF THE PREVALENCE OF RENAL IMPAIRMENT IN PATIENTS WITH TESTICULAR CANCER RECEIVING *CISPLATIN-BASED CHEMOTHERAPY

Abstract

Cisplatin-based chemotherapy remains the cornerstone of curative treatment for testicular cancer, but its clinical utility is constrained by the risk of renal impairment. This prospective meta-analysis investigates the prevalence and risk stratification of renal dysfunction among patients receiving systemic cisplatin regimens for testicular malignancies. Using standardized renal outcome definitions (≥20% decline in estimated glomerular filtration rate; ≥0.3 mg/dL increase in serum creatinine), renal impairment incidence was evaluated across cohorts (n ≈ 433). The overall prevalence of nephrotoxicity was 26.8%, with a mean decline in GFR of 22.4 ± 5.8 mL/min/1.73 m² post-treatment (p <0.001). Stratification showed significantly higher risk among patients with pre-existing reduced baseline GFR (p = 0.002) and higher cumulative cisplatin exposure (p = 0.001). Multivariate logistic models identified cumulative dose and baseline renal reserve as independent predictors of toxicity. These findings highlight that despite modern hydration and supportive care, renal impairment affects over one-quarter of testicular cancer patients undergoing cisplatin chemotherapy. The study underscores the need for proactive risk assessment and individualized dosing strategies to optimize therapeutic efficacy while minimizing nephrotoxicity.