Hyponatremia timing, incidence, and associated risk factors in patients treated with cisplatin for lung cancer: a retrospective study
Main Article Content
Keywords
cisplatin, hyponatremia, hydration, cancer
Abstract
The incidence of cisplatin-derived hyponatremia remains unknown, although nausea, vomiting, and renal dysfunction are common adverse events of cisplatin, a platinum-based preparation. The factor contributing to hyponatremia are described but not well known. This study aimed to retrospectively investigate the incidence of hyponatremia, timing, and associated risk factors. This study surveyed patients with lung cancer who received cisplatin chemotherapy from August 2013 to July 2019 at Shizuoka Cancer Center. The severity of hyponatremia was evaluated based on Common Terminology Criteria for Adverse Events. A total of 814 patients were included in this study. 682 (83.7%) patients had hyponatremia of any grade: grade 1 (<135–130 mmol/L), grade 3 (<130–120 mmol/L), and grade 4 (<120 mmol/L) hyponatremia were observed in 619 (76.0%), 51 (6.3%), and 12 (1.5%) patients, respectively. Of 63 patients with grade 3–4 hyponatremia, 43 (68.3%) developed it in the first treatment cycle. In multivariate analysis, the short hydration regimen (<3000 mL/day) have a lower incidence of grade 3–4 hyponatremia than a normal (>3000 mL) hydration regimen (OR: 0.35 [0.16-0.80], p = 0.013). In addition, if the Na+ value before the start of administration is < 135mmol/L, the incidence of grade3 and 4 hyponatremia is higher (OR:0.14 [0.07-0.28], p < 0.001). Hyponatremia due to cisplatin is likely to occur in patients with low Na levels before administration, such as the elderly. Since short hydration might avoid the use of diuretics, hydration methods might need to be reconsidered from the perspective of preventing hyponatremia.
References
2. Ohe Y, Ohashi Y, Kubota K, Tamura T, Nakagawa K, Negoro S, et al. Randomized phase III study of cisplatin plus irinotecan versus carboplatin plus paclitaxel, cisplatin plus gemcit-abine, and cisplatin plus vinorelbine for advanced non-small-cell lung cancer: four-arm cooperative study in Japan. Ann Oncol. 2007;18(2):317–32
3. https://doi.org/10.1093/annonc/mdl3773. Crona DJ, Faso A, Nishijima TF, McGraw KA, Galsky MD, Milowsky MI. A systematic review of strategies to prevent cisplatin-induced nephrotox-icit y.Oncologist. 2017;22(5):609 – 619. htt ps://doi.org/10.1634/theoncologist.2016-0319
4. Niggebrugge-Mentink KL, Beex-Oosterhuis MM, Ter Horst PG, van de Poll ME, Dieleman HG, van Kesteren C. Difference in decline in renal func-tion due to cisplatin after a short or long hydration scheme in non–small-cell lung cancer: a retrospec-tive cohort study (HYCIS-XL). J Clin Pharm Ther. 2020;45(5):1153–8. ht t p s: //d oi.o r g /10.1111/jc p t .1320 0
5. Suzuki H, Ohsugi J, Saito T, Hoshino M, Higuchi M, Kitamura M, et al. Renal-salt wasting syndrome in a patient with CDDP containing che-motherapy for recurrent non-small-cell lung can-cer. Gan to Kagaku Ryoho. 2011;38(13):2635–8. https://doi.org/10.3121/cmr.2007.762
6. Morita D, Ichikura T, Kimura M, Chochi K, Saigusa S, Yaguchi Y, et al., Syndrome of inap-propriate antidiuretic hormone secretion follow-ing chemotherapy with cisplatinum and 5-FU in a patient with esophageal cancer.Jpn J Gastroenterol Surg. 2005;38(6):598–602. http://journal.jsgs.or.jp/pdf/038060598.pdf
7. Tiseo M, Martelli O, Mancuso A, Sormani MP, Bruzzi P, Di Salvia R, et al., Short hydration regimen and nephrotoxicity of intermediate to high-dose cisplatin-based chemo-therapy for outpatient treatment in lung cancer and mesothelioma. Tumori. 2007;93(2):138–44.
8. Horinouchi H, Kubota K, Itani H, Taniyama TK, Nakamichi S, Wakui H, et al., Short hydration in chemotherapy containing cisplatin (≥ 75 mg/m2) for patients with lung cancer: a prospective study. Jpn J Clin Oncol. 2013;43(11):1105–9. htt ps://doi.org /10.1093/jjco/ hy t122
9. Hotta K, Takigawa N, Hisamoto-Sato A, Ichihara E, Kudo K, Uchida K, et al., Reappraisal of short-term low-volume hydration in cisplatin- based chemotherapy: results of a prospectivefeasibility study in advanced lung cancer in the Okayama lung cancer study group trial 1002. Jpn J Clin Oncol. 2013;43(11):1115–23. htt ps://doi.org /10.1093/jjco/ hy t128
10. Yajima Y, Fujii M, Tokumaru Y, Habu N. Hyponatremia with cisplatin administration in head and neck cancer patients. Gan to Kagaku Ryoho. 2010;37(13):2861–5. ht t ps://doi.org /10.4103/ijn.IJN_247_19
11. Ezoe Y, Mizusawa J, Katayama H, Kataoka K, Muto M. An integrated analysis of hyponatremia in cancer patients receiving platinum-based or nonplatinum-based chemotherapy in clinical tri-als (JCOG1405-A). Oncotarget. 2018;9(5):6595. https://doi.org/10.18632/oncotarget.23536
12. Hotta K, Ninomiya K, Takigawa N, Tanimoto M, Kiura K. Reappraisal of short-term low-vol-ume hydration in cisplatin-based chemother-apy; hoping for it as a public domain. Jpn J Clin Oncol. 2015;45(6):603– 4. ht t ps://doi.org /10.1093/jjco/hyt128
13. Hatakeyama S, Shida T, Yamaguchi H. Risk fac-tors for severe hyponatremia related to cisplatin: a retrospective case-control study. Biol Pharm Bull.2019;42(11):1891–7. https://doi.org/10.1248/bpb.b19-00477
14. Ohki T, Shioda Y, Tagawa K. Tolvaptan improved not only ascites but also overall survival in decom-pensated cirrhosis patients with hyponatremia. Jpn J Portal Hypertens. 2016;22(4):245–50.
15. Renneboog B, Musch W, Vandemergel X, Manto MU, Decaux G. Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med. 2006;119(1):71. https://doi.org/10.1016/j.amjmed.2005.09.026
16. Pera Jr MF, Zook BC, Harder HC. Effects of mannitol or furosemide diuresis on the neph-rotoxicity and physiological disposition of cis-dichlorodiammineplatinum-(II) in rats. Cancer Res. 1979;39(4):1269–1278.
17. National Comprehensive Cancer Network Chemotherapy Order Templates (NCCN Templates®). Available online at: http://www.nccn.org/templates/; accessed September 14, 2022.
18. Schrier RW. Water and sodium retention in edem-atous disorders: role of vasopressin and aldoste-rone. Am J Med. 2006;119(7): S47–S53. htt ps://doi.org/10.1016/j.amjmed.2006.05.007
19. Sandler AB, Nemunaitis J, Denham C, Von Pawel J, Cormier Y, Gatzemeier U, Einhorn LH. Phase III trial of gemcitabine plus cisplatin versus cisplatin alone in patients with locally advanced or metastatic non–small-cell lung cancer. J Clin Oncol. 2000;18(1):122. ht t ps://doi.org /10.1200/JCO.2000.18.1.122
20. Morabito A, Gebbia V, Di Maio M, Cinieri S, Viganò MG, Bianco R, et al., Randomized phase III trial of gemcitabine and cisplatin vs. gemcit-abine alone in patients with advanced non-small cell lung cancer and a performance status of 2: the CAPPA-2 study. Lung Cancer. 2013;81(1):77–83. https://doi.org/10.1016/j.lungcan.2013.04.008
21. Ohtaka M, Hattori Y, Kumano Y, Maeda Y, Kondo T, Mochizuki T, et al., Severe hyponatre-mia after cisplatin-based chemotherapy: two case reports. Hinyokika kiyo.2016;62(7):361–6. htt ps://doi.org/10.14989/ActaUrolJap_62_7_361
22. Rose B, Post T. Clinical physiology of acid-base and electrolyte disorders (clinical physiology of acid base & electrolyte disorders). 5th ed.McGraw-HillEducation, 2001
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.