Mannitol for the prevention of cisplatin-induced nephrotoxicity: A retrospective comparison of hydration plus mannitol versus hydration alone in inpatient and outpatient regimens at a large academic medical center
Background Cisplatin-induced nephrotoxicity is a dose limiting adverse effect that occurs in nearly one-third of patients. Mannitol administration has been used as a means to negate this toxicity. Data regarding the efficacy of mannitol use in this context are conflicting and limited. Objective The...
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Veröffentlicht in: | Journal of oncology pharmacy practice 2017-09, Vol.23 (6), p.422-428 |
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description | Background
Cisplatin-induced nephrotoxicity is a dose limiting adverse effect that occurs in nearly one-third of patients. Mannitol administration has been used as a means to negate this toxicity. Data regarding the efficacy of mannitol use in this context are conflicting and limited.
Objective
The aim of this study is to evaluate the effect of mannitol on renal function and describe the incidence of cisplatin-induced nephrotoxicity.
Methods
This study is a quasi-experimental retrospective analysis approved by the Institutional Review Board of inpatient and outpatient adults receiving cisplatin doses ≥40 mg/m2. The primary outcome was mean change in serum creatinine from baseline. Secondary outcomes included incidences of various grades of nephrotoxicity.
Results
A total of 313 patients (95 treated with mannitol and 218 without) were evaluated. The average increase in serum creatinine (mg/dL) was lower in patients who received mannitol versus those who did not (0.30 vs. 0.47; 95% confidence interval for difference, 0.03 to 0.31; P = 0.02). Grade 2 or higher nephrotoxicity occurred less frequently in patients who received mannitol versus those who did not (8% vs. 17%; P = 0.04). Non-gynecologic regimens and those who received doses ≥70 mg/m2 of cisplatin had lower rates of grade 2 or higher nephrotoxicity with mannitol (6% vs. 23%; P = 0.001, and 7% vs. 22%; P = 0.03, respectively).
Conclusion
The use of mannitol reduces the incidence and severity of nephrotoxicity in patients treated with cisplatin. The results of the study suggest mannitol may be most effective when used with non-gynecologic regimens and with cisplatin doses ≥70 mg/m2. |
doi_str_mv | 10.1177/1078155216656927 |
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fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1931913758</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_1078155216656927</sage_id><sourcerecordid>1931913758</sourcerecordid><originalsourceid>FETCH-LOGICAL-c431t-8a04a445252071af4f182a51f3f05537a2e48f5c8983e42e53836f9d1820e7ab3</originalsourceid><addsrcrecordid>eNp1Uc1rFDEUD6LYWr17koDnqfmYTDLeSlErVLwoeBteMy-7KTPJmGSW7h_q_2PqdlUEIZC8_L5e8gh5ydk551q_4UwbrpTgXae6XuhH5JS3WjesF98e13OFm3v8hDzL-ZYxZrQwT8mJ0FKJjqtT8uMThOBLnKiLiZYt0iXhDkPxMdDoqPV5maD40PgwrhZHGnDZpljinbe-7N_SC5qwpJgXtMXvkNo4L5B8Pui3-zHBL7NlWjOdj2k7TLnWf2CYYkDqQ11LvakdUAgjjWs5lgk3fsaQKVSITpA2SMHCiLO3dMbRW5iorUxMz8kTB1PGFw_7Gfn6_t2Xy6vm-vOHj5cX141tJS-NAdZC2yqhBNMcXOu4EaC4k44pJTUIbI1T1vRGYitQSSM714-VxVDDjTwjrw--S4rfV8xluI1rCjVy4L3kPZdamcpiB5at35QTumFJfoa0Hzgb7uc4_DvHKnn1YLze1Kf9FhwHVwnNgZBhg3-l_s_wJ6Znqrg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1931913758</pqid></control><display><type>article</type><title>Mannitol for the prevention of cisplatin-induced nephrotoxicity: A retrospective comparison of hydration plus mannitol versus hydration alone in inpatient and outpatient regimens at a large academic medical center</title><source>Access via SAGE</source><source>MEDLINE</source><creator>Williams, Robert P ; Ferlas, Brandon W ; Morales, Paul C ; Kurtzweil, Andy J</creator><creatorcontrib>Williams, Robert P ; Ferlas, Brandon W ; Morales, Paul C ; Kurtzweil, Andy J</creatorcontrib><description>Background
Cisplatin-induced nephrotoxicity is a dose limiting adverse effect that occurs in nearly one-third of patients. Mannitol administration has been used as a means to negate this toxicity. Data regarding the efficacy of mannitol use in this context are conflicting and limited.
Objective
The aim of this study is to evaluate the effect of mannitol on renal function and describe the incidence of cisplatin-induced nephrotoxicity.
Methods
This study is a quasi-experimental retrospective analysis approved by the Institutional Review Board of inpatient and outpatient adults receiving cisplatin doses ≥40 mg/m2. The primary outcome was mean change in serum creatinine from baseline. Secondary outcomes included incidences of various grades of nephrotoxicity.
Results
A total of 313 patients (95 treated with mannitol and 218 without) were evaluated. The average increase in serum creatinine (mg/dL) was lower in patients who received mannitol versus those who did not (0.30 vs. 0.47; 95% confidence interval for difference, 0.03 to 0.31; P = 0.02). Grade 2 or higher nephrotoxicity occurred less frequently in patients who received mannitol versus those who did not (8% vs. 17%; P = 0.04). Non-gynecologic regimens and those who received doses ≥70 mg/m2 of cisplatin had lower rates of grade 2 or higher nephrotoxicity with mannitol (6% vs. 23%; P = 0.001, and 7% vs. 22%; P = 0.03, respectively).
Conclusion
The use of mannitol reduces the incidence and severity of nephrotoxicity in patients treated with cisplatin. The results of the study suggest mannitol may be most effective when used with non-gynecologic regimens and with cisplatin doses ≥70 mg/m2.</description><identifier>ISSN: 1078-1552</identifier><identifier>EISSN: 1477-092X</identifier><identifier>DOI: 10.1177/1078155216656927</identifier><identifier>PMID: 27352615</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Academic Medical Centers ; Adult ; Aged ; Antineoplastic Agents - adverse effects ; Chemotherapy ; Cisplatin ; Cisplatin - adverse effects ; Creatinine ; Drug therapy ; Female ; Health care facilities ; Humans ; Hydration ; Incidence ; Inpatients ; Kidney Diseases - chemically induced ; Kidney Diseases - prevention & control ; Male ; Mannitol ; Mannitol - administration & dosage ; Middle Aged ; Outpatients ; Renal function ; Retrospective Studies ; Studies ; Toxicity</subject><ispartof>Journal of oncology pharmacy practice, 2017-09, Vol.23 (6), p.422-428</ispartof><rights>The Author(s) 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c431t-8a04a445252071af4f182a51f3f05537a2e48f5c8983e42e53836f9d1820e7ab3</citedby><cites>FETCH-LOGICAL-c431t-8a04a445252071af4f182a51f3f05537a2e48f5c8983e42e53836f9d1820e7ab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1078155216656927$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1078155216656927$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27352615$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Williams, Robert P</creatorcontrib><creatorcontrib>Ferlas, Brandon W</creatorcontrib><creatorcontrib>Morales, Paul C</creatorcontrib><creatorcontrib>Kurtzweil, Andy J</creatorcontrib><title>Mannitol for the prevention of cisplatin-induced nephrotoxicity: A retrospective comparison of hydration plus mannitol versus hydration alone in inpatient and outpatient regimens at a large academic medical center</title><title>Journal of oncology pharmacy practice</title><addtitle>J Oncol Pharm Pract</addtitle><description>Background
Cisplatin-induced nephrotoxicity is a dose limiting adverse effect that occurs in nearly one-third of patients. Mannitol administration has been used as a means to negate this toxicity. Data regarding the efficacy of mannitol use in this context are conflicting and limited.
Objective
The aim of this study is to evaluate the effect of mannitol on renal function and describe the incidence of cisplatin-induced nephrotoxicity.
Methods
This study is a quasi-experimental retrospective analysis approved by the Institutional Review Board of inpatient and outpatient adults receiving cisplatin doses ≥40 mg/m2. The primary outcome was mean change in serum creatinine from baseline. Secondary outcomes included incidences of various grades of nephrotoxicity.
Results
A total of 313 patients (95 treated with mannitol and 218 without) were evaluated. The average increase in serum creatinine (mg/dL) was lower in patients who received mannitol versus those who did not (0.30 vs. 0.47; 95% confidence interval for difference, 0.03 to 0.31; P = 0.02). Grade 2 or higher nephrotoxicity occurred less frequently in patients who received mannitol versus those who did not (8% vs. 17%; P = 0.04). Non-gynecologic regimens and those who received doses ≥70 mg/m2 of cisplatin had lower rates of grade 2 or higher nephrotoxicity with mannitol (6% vs. 23%; P = 0.001, and 7% vs. 22%; P = 0.03, respectively).
Conclusion
The use of mannitol reduces the incidence and severity of nephrotoxicity in patients treated with cisplatin. The results of the study suggest mannitol may be most effective when used with non-gynecologic regimens and with cisplatin doses ≥70 mg/m2.</description><subject>Academic Medical Centers</subject><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>Chemotherapy</subject><subject>Cisplatin</subject><subject>Cisplatin - adverse effects</subject><subject>Creatinine</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Health care facilities</subject><subject>Humans</subject><subject>Hydration</subject><subject>Incidence</subject><subject>Inpatients</subject><subject>Kidney Diseases - chemically induced</subject><subject>Kidney Diseases - prevention & control</subject><subject>Male</subject><subject>Mannitol</subject><subject>Mannitol - administration & dosage</subject><subject>Middle Aged</subject><subject>Outpatients</subject><subject>Renal function</subject><subject>Retrospective Studies</subject><subject>Studies</subject><subject>Toxicity</subject><issn>1078-1552</issn><issn>1477-092X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1Uc1rFDEUD6LYWr17koDnqfmYTDLeSlErVLwoeBteMy-7KTPJmGSW7h_q_2PqdlUEIZC8_L5e8gh5ydk551q_4UwbrpTgXae6XuhH5JS3WjesF98e13OFm3v8hDzL-ZYxZrQwT8mJ0FKJjqtT8uMThOBLnKiLiZYt0iXhDkPxMdDoqPV5maD40PgwrhZHGnDZpljinbe-7N_SC5qwpJgXtMXvkNo4L5B8Pui3-zHBL7NlWjOdj2k7TLnWf2CYYkDqQ11LvakdUAgjjWs5lgk3fsaQKVSITpA2SMHCiLO3dMbRW5iorUxMz8kTB1PGFw_7Gfn6_t2Xy6vm-vOHj5cX141tJS-NAdZC2yqhBNMcXOu4EaC4k44pJTUIbI1T1vRGYitQSSM714-VxVDDjTwjrw--S4rfV8xluI1rCjVy4L3kPZdamcpiB5at35QTumFJfoa0Hzgb7uc4_DvHKnn1YLze1Kf9FhwHVwnNgZBhg3-l_s_wJ6Znqrg</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Williams, Robert P</creator><creator>Ferlas, Brandon W</creator><creator>Morales, Paul C</creator><creator>Kurtzweil, Andy J</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>20170901</creationdate><title>Mannitol for the prevention of cisplatin-induced nephrotoxicity: A retrospective comparison of hydration plus mannitol versus hydration alone in inpatient and outpatient regimens at a large academic medical center</title><author>Williams, Robert P ; Ferlas, Brandon W ; Morales, Paul C ; Kurtzweil, Andy J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c431t-8a04a445252071af4f182a51f3f05537a2e48f5c8983e42e53836f9d1820e7ab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Academic Medical Centers</topic><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>Chemotherapy</topic><topic>Cisplatin</topic><topic>Cisplatin - adverse effects</topic><topic>Creatinine</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Health care facilities</topic><topic>Humans</topic><topic>Hydration</topic><topic>Incidence</topic><topic>Inpatients</topic><topic>Kidney Diseases - chemically induced</topic><topic>Kidney Diseases - prevention & control</topic><topic>Male</topic><topic>Mannitol</topic><topic>Mannitol - administration & dosage</topic><topic>Middle Aged</topic><topic>Outpatients</topic><topic>Renal function</topic><topic>Retrospective Studies</topic><topic>Studies</topic><topic>Toxicity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Williams, Robert P</creatorcontrib><creatorcontrib>Ferlas, Brandon W</creatorcontrib><creatorcontrib>Morales, Paul C</creatorcontrib><creatorcontrib>Kurtzweil, Andy J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Journal of oncology pharmacy practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Williams, Robert P</au><au>Ferlas, Brandon W</au><au>Morales, Paul C</au><au>Kurtzweil, Andy J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mannitol for the prevention of cisplatin-induced nephrotoxicity: A retrospective comparison of hydration plus mannitol versus hydration alone in inpatient and outpatient regimens at a large academic medical center</atitle><jtitle>Journal of oncology pharmacy practice</jtitle><addtitle>J Oncol Pharm Pract</addtitle><date>2017-09-01</date><risdate>2017</risdate><volume>23</volume><issue>6</issue><spage>422</spage><epage>428</epage><pages>422-428</pages><issn>1078-1552</issn><eissn>1477-092X</eissn><abstract>Background
Cisplatin-induced nephrotoxicity is a dose limiting adverse effect that occurs in nearly one-third of patients. Mannitol administration has been used as a means to negate this toxicity. Data regarding the efficacy of mannitol use in this context are conflicting and limited.
Objective
The aim of this study is to evaluate the effect of mannitol on renal function and describe the incidence of cisplatin-induced nephrotoxicity.
Methods
This study is a quasi-experimental retrospective analysis approved by the Institutional Review Board of inpatient and outpatient adults receiving cisplatin doses ≥40 mg/m2. The primary outcome was mean change in serum creatinine from baseline. Secondary outcomes included incidences of various grades of nephrotoxicity.
Results
A total of 313 patients (95 treated with mannitol and 218 without) were evaluated. The average increase in serum creatinine (mg/dL) was lower in patients who received mannitol versus those who did not (0.30 vs. 0.47; 95% confidence interval for difference, 0.03 to 0.31; P = 0.02). Grade 2 or higher nephrotoxicity occurred less frequently in patients who received mannitol versus those who did not (8% vs. 17%; P = 0.04). Non-gynecologic regimens and those who received doses ≥70 mg/m2 of cisplatin had lower rates of grade 2 or higher nephrotoxicity with mannitol (6% vs. 23%; P = 0.001, and 7% vs. 22%; P = 0.03, respectively).
Conclusion
The use of mannitol reduces the incidence and severity of nephrotoxicity in patients treated with cisplatin. The results of the study suggest mannitol may be most effective when used with non-gynecologic regimens and with cisplatin doses ≥70 mg/m2.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>27352615</pmid><doi>10.1177/1078155216656927</doi><tpages>7</tpages></addata></record> |
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subjects | Academic Medical Centers Adult Aged Antineoplastic Agents - adverse effects Chemotherapy Cisplatin Cisplatin - adverse effects Creatinine Drug therapy Female Health care facilities Humans Hydration Incidence Inpatients Kidney Diseases - chemically induced Kidney Diseases - prevention & control Male Mannitol Mannitol - administration & dosage Middle Aged Outpatients Renal function Retrospective Studies Studies Toxicity |
title | Mannitol for the prevention of cisplatin-induced nephrotoxicity: A retrospective comparison of hydration plus mannitol versus hydration alone in inpatient and outpatient regimens at a large academic medical center |
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