J Cancer 2017; 8(19):3939-3944. doi:10.7150/jca.20083

Research Paper

Cisplatin Nephrotoxicity Might Have a Sex Difference. An analysis Based on Women's Sex Hormone Changes.

Wei-Yu Chen1*, Ching-Hsing Hsiao2*, Yi-Chen Chen3, Chung-Han Ho3,4,5, Jhi-Joung Wang6, Chung-Hsi Hsing7,8, Hsien-Yi Wang9,10, Wei-Chih Kan9,11, Chia-Chun Wu4,9✉

1. Department of Hematology and Oncology, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan.
2. Department of Ophthalmology, Chi Mei Hospital, Jiali District, Tainan, Taiwan.
3. Department of Medical Research, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan.
4. Department of Pharmacy, Chia Nan University of Pharmacy and Science, Rende District, Tainan, Taiwan.
5. Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
6. Department of Medical Research, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan.
7. Department of Anesthesiology, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan.
8. Department of Anesthesiology, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
9. Department of Nephrology, Department of Internal medicine, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan.
10. Department of Sports Management, College of Leisure and Recreation Management, Chia Nan University of Pharmacy and Science, Rende District, Tainan, Taiwan.
11. Department of Biological Science and Technology, Chung Hwa University of Medical Technology, Rende District, Tainan City 717, Taiwan.
* Wei-Yu Chen and Ching-Hsing Hsiao contributed equally to the writing of this work.

Abstract

Background: A sex difference in cisplatin-induced nephrotoxicity (CIN) has been reported in human and animal studies. We examined in humans whether it is associated with sex-hormone changes.

Methods: In this retrospective nationwide cohort study, we used Taiwan's National Health Insurance Research Database (NHIRD) to identify patients with a history of malignancy and cisplatin treatment. Patients diagnosed with kidney disease before cisplatin treatment and those with sex-organ malignancies were excluded. A diagnosis of kidney disease within 90 days after the first administration of cisplatin was the study outcome. Risk factors were estimated using a Cox regression model. Subgroup analyses were performed based on different women's estrogen levels in phases of childbearing, perimenopause, and postmenopause.

Results: A retrospective analysis of the records of 3973 men (mean age: 56.15 ± 12.85 years) and 1154 women (mean age: 56.31 ± 12.40 years) showed that 1468 (36.95%) men and 451 (39.08%) women had a new diagnosis of kidney disease. The risk factors were being > 55 years old, a high comorbidity score, and a history of aminoglycoside treatment. Only postmenopausal women had a significantly higher risk of kidney injury (hazard ratio: 1.28; 95% CI: 1.02-1.61) than did men.

Conclusions: Perimenopausal women have a significantly higher risk of CIN than do men, which might be explained by women's higher levels of estrogen. Additional studies on the underlying mechanisms of the sex difference of CIN are needed.

Keywords: cisplatin, nephrotoxicity, sex difference, chronic kidney disease, acute kidney disease

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How to cite this article:
Chen WY, Hsiao CH, Chen YC, Ho CH, Wang JJ, Hsing CH, Wang HY, Kan WC, Wu CC. Cisplatin Nephrotoxicity Might Have a Sex Difference. An analysis Based on Women's Sex Hormone Changes.. J Cancer 2017; 8(19):3939-3944. doi:10.7150/jca.20083. Available from http://www.jcancer.org/v08p3939.htm