Cisplatin nephrotoxicity might have a sex difference. an analysis based on women's sex hormone changes

Wei Yu Chen, Ching Hsing Hsiao, Yi Chen Chen, Chung Han Ho, Jhi Joung Wang, Chung Hsi Hsing, Hsien Yi Wang, Wei Chih Kan, Chia Chun Wu

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)3939-3944
Number of pages6
JournalJournal of Cancer
Volume8
Issue number19
DOIs
Publication statusPublished - 2017

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Gonadal Steroid Hormones
Sex Characteristics
Cisplatin
Kidney Diseases
Estrogens
Perimenopause
Postmenopause
National Health Programs
Aminoglycosides
Taiwan
Proportional Hazards Models
Comorbidity
Neoplasms
Cohort Studies
Therapeutics
Outcome Assessment (Health Care)
Databases
Kidney
Wounds and Injuries
Research

Keywords

  • Acute kidney disease
  • Chronic kidney disease
  • Cisplatin
  • Nephrotoxicity
  • Sex difference

ASJC Scopus subject areas

  • Oncology

Cite this

Chen, W. Y., Hsiao, C. H., Chen, Y. C., Ho, C. H., Wang, J. J., Hsing, C. H., ... Wu, C. C. (2017). Cisplatin nephrotoxicity might have a sex difference. an analysis based on women's sex hormone changes. Journal of Cancer, 8(19), 3939-3944. https://doi.org/10.7150/jca.20083

Cisplatin nephrotoxicity might have a sex difference. an analysis based on women's sex hormone changes. / Chen, Wei Yu; Hsiao, Ching Hsing; Chen, Yi Chen; Ho, Chung Han; Wang, Jhi Joung; Hsing, Chung Hsi; Wang, Hsien Yi; Kan, Wei Chih; Wu, Chia Chun.

In: Journal of Cancer, Vol. 8, No. 19, 2017, p. 3939-3944.

Research output: Contribution to journalArticle

Chen, WY, Hsiao, CH, Chen, YC, Ho, CH, Wang, JJ, Hsing, CH, Wang, HY, Kan, WC & Wu, CC 2017, 'Cisplatin nephrotoxicity might have a sex difference. an analysis based on women's sex hormone changes', Journal of Cancer, vol. 8, no. 19, pp. 3939-3944. https://doi.org/10.7150/jca.20083
Chen, Wei Yu ; Hsiao, Ching Hsing ; Chen, Yi Chen ; Ho, Chung Han ; Wang, Jhi Joung ; Hsing, Chung Hsi ; Wang, Hsien Yi ; Kan, Wei Chih ; Wu, Chia Chun. / Cisplatin nephrotoxicity might have a sex difference. an analysis based on women's sex hormone changes. In: Journal of Cancer. 2017 ; Vol. 8, No. 19. pp. 3939-3944.
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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.",
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