Association between baseline hypertension and cisplatin-induced nephrotoxicity in patients receiving short hydration

Cisplatin (CDDP)-induced nephrotoxicity (CIN) commonly arises during CDDP-based therapy. Hypertension (HT) has been identified as a potential risk factor for CIN, although other possible covariates cannot be excluded, without sufficient CIN prophylaxis. This study evaluated the association of baseline HT and CIN, utilizing the short hydration method, considered the most advanced CIN prevention approach, in a real-world setting. Patients with thoracic cancer undergoing CDDP (≥ 75 mg/m 2 )-based treatment with the short hydration method ( n = 244) were retrospectively evaluated. Patients were classified into the HT group, including patients requiring pharmacotherapy at baseline, and a control group without HT. CIN was observed in 18.0% of patients in the HT group across all treatment cycles, significantly higher than the control group (6.0%, P = 0.008), meeting the primary endpoint. The maximum changes in serum creatinine levels and creatinine clearance from baseline were notably worse in the HT group compared to the control group ( P = 0.009 and P = 0.0496, respectively). Similar outcomes were observed in the propensity score-matched cohort. Even after excluding patients concurrently administered bevacizumab, consistent results were obtained. In summary, patients with baseline HT complications are at high risk of developing CIN with short hydration.