5PSQ-151 Incidence of nephrotoxicity in cisplatin administration associated with a hydration protocol

<h3>Background and Importance</h3> Cisplatin for solid tumours presents potential nephrotoxicity, necessitating hydration and supplementation protocols. The literature on this topic is diverse and often contradictory, highlighting the importance of identifying risk factors and optimising the management of its complications in clinical practice. <h3>Aim and Objectives</h3> To determine the incidence of nephrotoxicity in patients receiving cisplatin-based regimens under a nephrotoxicity prevention protocol established in 2016 by pharmacists and oncologists, while also analysing associated risk factors. <h3>Material and Methods</h3> A retrospective observational study was conducted in a secondary-level hospital. Inclusion criteria involved patients treated with at least two cycles of cisplatin between January and December 2023. The protocol is as follows: For cisplatin doses ≥60mg/m², prehydration involves administering 2L of sodium chloride 0.9% (NaCl) containing 20 mEq of potassium chloride and 20 mg of furosemide over 2 hours, followed by 1L NaCl administered post-cisplatin over 1 hour. For doses &lt;60 mg/m², 1L is given over 1 hour for both pre- and post-hydration with the same additives. Nephrotoxicity was assessed using CTCAEv5.0 criteria, defined as an increase in creatinine ≥0.5 mg/dL or increased creatinine≥ grade 1. Data were collected from electronic medical records including: age, anthropometric data, comorbidities (hypertension, diabetes, concomitant radiotherapy or nephrotoxic drugs), renal function parameters before and after treatment (creatinine levels and glomerular filtration rate per CKD-EPI), cisplatin dose, cumulative dose, and number of cycles. Statistical analysis included multivariate logistic regression using SPSS v21. <h3>Results</h3> A total of 75 patients (53% men) were included, with a mean age of 60.1 years (95% CI: 57.4–62.9). Fifty-two percent received cisplatin doses &lt;60 mg/m², with head and neck cancer being the primary diagnosis in 34.7% of patients. The cumulative cisplatin dose averaged 223.49 mg (95% CI: 201.71–245.27), with a median of 4 cycles. Nephrotoxicity prevalence was 13.3%, with a mean glomerular filtration rate reduction from 94.1 mL/min to 86.2 mL/min post-treatment. Maximum nephrotoxicity was grade-1, with only 4% requiring dose adjustment. No correlation was found between nephrotoxicity and age, comorbidities or cisplatin dose. <h3>Conclusion and Relevance</h3> The nephrotoxicity prevention protocol implemented in 2016 demonstrates a low incidence of nephrotoxicity, with a maximum grade of 1 among patients treated with cisplatin. However, the absence of clear predictive factors highlights the need for further studies to enhance and optimise future preventive measures. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest