Acute kidney disease following cisplatin treatment in head and neck cancer: risk factors and survival impact

BackgroundAcute kidney disease (AKD), representing persistent or subacute kidney dysfunction occurring within 7 to 90 days, has emerged as an important framework bridging acute kidney injury (AKI) and chronic kidney disease. However, the occurrence and long-term clinical implications of AKD following cisplatin treatment in patients with head and neck squamous cell carcinoma (HNSCC) remain incompletely characterized.MethodsThis study retrospectively analyzed patients with HNSCC treated with cisplatin using a longitudinal institutional clinical database. AKD was classified using the prespecified renal-function criteria applied in the original data-extraction algorithm during the 7–90-day period following cisplatin treatment. Clinical characteristics, AKD occurrence, and 5-year all-cause mortality were evaluated.ResultsAmong the 2,033 patients, AKD occurred in 575 (28.3%) patients. Diabetes mellitus was more prevalent among patients with AKD than among those without AKD (20.0% vs. 12.3%, p < 0.001) in univariable analysis. In the prespecified Cox model, the association between AKD and 5-year all-cause mortality did not reach statistical significance (adjusted HR, 1.09; 95% CI, 0.94–1.25). Only two ESKD events were observed during follow-up (0.1%).ConclusionAKD was observed in 28.3% of this historical cohort of patients with HNSCC treated with cisplatin. Diabetes mellitus was more prevalent among patients with AKD in univariable analysis. The association between AKD and 5-year all-cause mortality did not reach statistical significance in the prespecified adjusted model, although the confidence interval did not exclude a clinically meaningful increase in risk.