Kidney Week

Abstract: SA-PO205

Association between AKI during Cisplatin Therapy in Children with CKD and Hypertension at 12 and 36 Months after Therapy End

Session Information

• Onconephrology: Kidney Outcomes during Cancer Treatment and Nephropathies
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Onconephrology

• 1700 Onconephrology

Authors

• Abrahim, Salma, The Hospital for Sick Children Child Health Evaluative Sciences, Toronto, Ontario, Canada

Salma Abrahim, MSc

• Lebel, Asaf, The Hospital for Sick Children Department of Paediatrics, Toronto, Ontario, Canada

Asaf Lebel, MD

• McMahon, Kelly, McGill University Health Centre, Montreal, Quebec, Canada

Kelly McMahon, PhD

• Cockovski, Vedran, The Hospital for Sick Children Child Health Evaluative Sciences, Toronto, Ontario, Canada

Vedran Cockovski

• Wang, Stella Qiongbin, The Hospital for Sick Children Child Health Evaluative Sciences, Toronto, Ontario, Canada

Stella Qiongbin Wang, MS, MSc

• Lee, Jasmine, The Hospital for Sick Children Child Health Evaluative Sciences, Toronto, Ontario, Canada

Jasmine Lee, MSc

• Zappitelli, Michael, The Hospital for Sick Children Child Health Evaluative Sciences, Toronto, Ontario, Canada

Michael Zappitelli, MD, MSc

• Study Group, Able, The Hospital for Sick Children Child Health Evaluative Sciences, Toronto, Ontario, Canada

Able Study Group

Background

Cisplatin (CisP) may cause acute kidney injury (AKI) in children treated for cancer. Predicting post-CisP chronic kidney disease (CKD) or elevated blood pressure or hypertension (≥eBP) remains elusive. We determined: 1) adjusted associations of AKI during CisP therapy with CKD and ≥eBP at 12 and 36 months(M) post-therapy end; 2) whether CKD and ≥eBP at 3M are associated with CKD and ≥eBP at 12 and 36M after CisP therapy end.

Methods

Multicenter prospective study of children treated with CisP followed throughout therapy and for 36M post-therapy end. Exclusion: pre-existing kidney conditions. Urine, blood, BP collected at 3, 12, and 36M post-CisP therapy. Exposures: a) serum creatinine (SCr)-AKI any time during CisP therapy, per KDIGO; b) severe electrolyte-defined AKI (eAKI) during CisP therapy per National Cancer Institute (NCI) v4.0 criteria; c) composite AKI (SCr-AKI and severe eAKI); d) presence of CKD or ≥eBP at 3M post-CisP therapy end. Outcomes at 12 and 36M post-CisP therapy: a) CKD (per KDIGO); b)≥eBP (per AAP guidelines); c) composite of CKD or ≥eBP. Analysis: 1) multiple logistic regression (MLR) to evaluate AKI – outcome association (stepwise covariate selection); 2) MLR to evaluate association between 3M and 12M/36M outcomes (for AKI interaction).

Results

Table shows prevalence of CKD and ≥eBP at 12 and 36M. Patients with SCr-AKI, eAKI and composite AKI were more likely to have ≥eBP at 12M. CKD or ≥eBP at 3M did not predict outcome presence at 12 and 36M (Table 1). However, patients with vs. without CKD at 12M were 4.8 times more likely to have CKD at 36M (Table 1).

Conclusion

HTN and CKD were common at 12 and 36M post-CisP therapy. AKI during therapy was associated with ≥eBP at 12M, but the presence of kidney or BP outcomes at 3M did not predict later CKD or HTN. Novel methods to predict kidney health outcomes and interventions to reduce AKI during therapy should be investigated.