Table 1.
Characteristics of study participants at early and late cisplatin visits by SCr-AKI status
| Characteristic | Early Visit | Late Visit | ||
|---|---|---|---|---|
| SCr-AKI (n=46) | No SCr-AKI (n=110) | SCr-AKI (n=22) | No SCr-AKI (n=105) | |
| Baseline (before first cisplatin infusion), n (%) | ||||
| Male | 22 (48) | 56 (51) | 8 (36) | 57 (54) |
| White race | 38 (83) | 78 (71) | 17 (77) | 80 (76) |
| Cancer diagnosisd | ||||
| CNS tumor a | 18 (39) | 38 (35) | 10 (46) | 37 (35) |
| Neuroblastoma | 18 (39) | 24 (22)b | 8 (36) | 21 (20) |
| Osteosarcoma | 2 (4) | 31 (28)c | 0 (0) | 28 (27)d |
| Germ cell tumor | 3 (7) | 11 (10) | 0 (0) | 13 (12) |
| Hepatoblastoma | 4 (9) | 5 (5) | 3 (14) | 6 (6) |
| Other e | 1 (2) | 1 (0.9) | 1 (5) | 0 (0) |
| Cancer involves one or both kidneys | 5 (11) | 5 (5) | 3 (14) | 3 (3) |
| Kidney medical historyf | 8 (17) | 5 (5)d | 1 (5) | 9 (9) |
| Nephrotoxic drug before first cisplating | 11 (24) | 15 (14) | N/A | N/A |
| Vancomycin in 2 weeks pre-cisplatin | 5 (11) | 3 (3)b | N/A | N/A |
| Immediately before/day of the early/late visit infusion | ||||
| Age at early/late visit, yr, median (IQR) | 3 (2–7) | 8 (3–13)d | 3 (2–4) | 7 (3–13)d |
| Age at early/late visit <3 years, n (%) | 25 (54) | 25 (23)c | 13 (59) | 29 (28)d |
| Cisplatin naive at the early visit, n (%) | 29 (63) | 60 (55) | N/A | N/A |
| Pre-visit eGFR, ml/min per 1.73 m2, median (IQR)h | 165 (138–206) | 133 (117–155)c | 170 (156–202) | 134 (119–162)c |
| The late visit was the last cisplatin cycle of cancer treatment, n (%) | N/A | N/A | 18 (82) | 86 (82) |
| Cumulative cisplatin dose before early/late visit, mg/m2, median (IQR) | 82 (77–127)i | 107 (77–119)i | 170 (156–204) | 225 (172–349)b |
| Early/late visit cisplatin infusion dose, mg/m2, median (IQR) | 59 (50–77) | 59 (50–74) | 73 (49–78) | 58 (37–71)b |
| Infection before early/late visit, n (%) | 6 (13) | 14 (133) | 11 (50) | 33 (31) |
| PICU admission before early/late visit, n (%) | 1 (2) | 1 (0.9) | 4 (18) | 7 (7) |
| SCr-AKI episode before early/late visit, n (%)j | 11 (24) | 8 (7)d | 14 (64) | 45 (43) |
| Days between early visit and late visit, median (IQR) | N/A | N/A | 43 (39–64) | 67 (42–117)b |
| Concurrent nephrotoxins at early/late visit, n (%)k | 3 (7) | 20 (18) | 2 (9) | 17 (16) |
| Cancer treatment details | ||||
| Early/late visit total cisplatin cycle dose, mg/m2, median (IQR) | 100 (77–193) | 107 (77–122) | 82 (76–155) | 100 (75–120) |
| Any flank (left or right), whole abdomen, pelvic, or total body radiation planned, n (%) | 10 (22) | 11 (10)b | 3 (14) | 10 (10) |
| Postcisplatin | ||||
| Early/late visit length of hospital stay, d, median (IQR) | 6 (5–21) | 5 (4–6)c | 5 (4–11) | 5 (3–6) |
| Nephrotoxins in 10 days after early/late visit, n (%)l | 5 (11) | 7 (6) | 1 (5) | 9 (9) |
Percentages are based on the total for each column. SCr-AKI, serum creatinine–defined AKI; CNS, central nervous system; N/A, not applicable; IQR, interquartile range; PICU, pediatric intensive care unit; CKiD, Chronic Kidney Disease in Children; SCr, serum creatinine.
CNS tumors at the early visit: astrocytoma (n=3), choroid plexus tumor (n=2), ependymoma (n=1), medulloblastoma (n=38), primitive neuroectodermal tumor (n=7), atypical teratoid/rhabdoid tumor (n=5). CNS tumors at the late visit: astrocytoma (n=2), choroid plexus tumor (n=2), ependymoma (n=1), medulloblastoma (n=32), primitive neuroectodermal tumor (n=7), atypical teratoid/rhabdoid tumor (n=3).
P<0.05, significant difference between AKI and non-AKI groups for that time point.
P<0.001, significant difference between AKI and non-AKI groups for that time point.
P<0.01, significant difference between AKI and non-AKI groups for that time point.
Other cancers at the early visit: lymphoma and nasopharyngeal carcinoma. Other cancer at the late visit: nasopharyngeal carcinoma.
Evidence of hypertension, treatment with antihypertensives, family history of kidney disease, CKD, dialysis, congenital renal anomaly, kidney stones, vesicoureteral reflux, urinary tract infection, serum electrolyte abnormality requiring treatment, or AKI by chart review.
Receipt of acyclovir, amphotericin, aminoglycosides (gentamicin, tobramycin, amikacin), vancomycin, angiotensin-converting enzyme inhibitor, ganciclovir/valganciclovir, ifosfamide, or methotrexate in 2 weeks precisplatin.
If age <18 years at visit, GFR was estimated using updated CKiD equation. If age >18 years, the average of the updated CKiD equation and the Chronic Kidney Disease Epidemiology Collaboration SCr–based equation was used.
Patients with SCr-AKI with data, n=17; Patients without SCr-AKI with data, n=50. These are the numbers of patients who were not cisplatin naive at the early visit.
To ascertain SCr-AKI before early/late visit, all routine and study-measured SCr values that occurred before cisplatin infusion of early/late visit were used. Peak SCr was the highest SCr occurring before early/late visit infusion but occurring after the baseline SCr. For SCr-AKI before the early visit, baseline SCr was the lowest routine value in 3 months precisplatin initiation. For AKI between the early and late visit, baseline SCr was the lowest routine or study-measured value in 3 months precisplatin initiation.
Acyclovir, amphotericin, aminoglycosides (gentamicin, tobramycin, amikacin), ifosfamide, or chemotherapy protocol indicating a nephrotoxin (aldesleukin, busulfan, carboplatin, dinutuximab, gemcitabine, lomustine, melphalan, methotrexate, radiotherapy, rituximab, stem cell transplant, or temsirolimus) was given within 24 hours of cisplatin infusion.
Acyclovir, amphotericin, aminoglycosides (gentamicin, tobramycin, amikacin), ifosfamide.