Development and validation of a risk prediction model for acute kidney injury after the first course of cisplatin

Shveta S. Motwani, Gearoid M. McMahon, Benjamin D. Humphreys, Ann H. Partridge, Sushrut S. Waikar, Gary C. Curhan

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58 Scopus citations

Abstract

Purpose Cisplatin-Associated acute kidney injury (C-AKI) is common. We sought to develop and validate a predictive model for C-AKI after the first course of cisplatin. Methods Clinical and demographic data were collected on patients who received cisplatin between 2000 and 2016 at two cancer centers. C-AKI was defined as a 0.3 mg/dL rise in serum creatinine within 14 days of receiving cisplatin. Using multivariable logistic regression models with C-AKI as the primary outcome, we created a scoring model from the development cohort (DC) and tested it in the validation cohort (VC). Results C-AKI occurred in 13.6% of 2,118 patients in the DC and in 11.6% of 2,363 patients in the VC. Factors significantly associated with C-AKI included age 61 to 70 years (odds ratio [OR], 1.64 [95% CI, 1.21 to 2.23]; P = .001) and 71 to 90 years (OR, 2.97 [95% CI, 2.06 to 4.28]; P , .001) compared with # 60 years; cisplatin dose 101 to 150 mg (OR, 1.58 [95% CI, 1.14 to 2.19]; P = .007) and . 150 mg (OR, 3.73 [95% CI, 2.68 to 5.20]; P , .001) compared with # 100 mg; a history of hypertension (OR, 2.10 [95% CI, 1.54 to 2.72]; P,.001) compared with no hypertension; and serum albumin 2.0 to 3.5 g/dL (OR, 2.21 [95% CI, 1.62 to 3.03]; P , .001) compared with . 3.5 g/dL. The baseline estimated glomerular filtration rate was not significantly associated with the risk of C-AKI. The c-statistics of the score-based model in the DC and the VC were 0.72 (95% CI, 0.69 to 0.75) and 0.70 (95% CI, 0.67 to 0.73), respectively. Scores of 0, 3.5, and 8.5 were associated with a probability of C-AKI of 0.03 (95% CI, 0.03 to 0.05), 0.12 (95% CI, 0.11 to 0.14), and 0.51 (95% CI, 0.43 to 0.60), respectively. Conclusion A score-based model created by using the patient's age, cisplatin dose, hypertension, and serum albumin is predictive of C-AKI.

Original languageEnglish
Pages (from-to)682-688
Number of pages7
JournalJournal of Clinical Oncology
Volume36
Issue number7
DOIs
StatePublished - Mar 1 2018

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