2026/04/14 by Juan J. Cintrón-García, Maulinkumar Patel, Clark R. Andersen +6 · 1 voice
Medicine · Agricultural and Biological Sciences · #Chemotherapy-induced organ toxicity mitigation #Chemotherapy-induced cardiotoxicity and mitigation #Sesame and Sesamin Research
paper · doi:10.1016/j.ekir.2026.106538
openalex publication_date 2026/04/14 · openalex created_date 2026/04/15 · openalex updated_date 2026/07/23
Introduction: Cisplatin is often nephrotoxic, frequently causing treatment interruptions or discontinuation. Mitigation includes dose adjustments, hydration, and supplemental magnesium. Sodium-glucose cotransporter-2 inhibitors (SGLT2is) may protect the kidneys by reducing tubular cells' cisplatin uptake. We examined the potential kidney protective effect of SGLT2i in patients with cancer having diabetes mellitus receiving cisplatin. Methods: We conducted a single-center retrospective study of patients who received i.v. cisplatin from July 2017 to January 2024. Data extracted included comorbidities, variables associated with acute kidney injury (AKI; defined as ≥ 50% serum creatinine increase within 4 weeks), hyponatremia, hypomagnesemia, and anemia. Patients were divided according to SGLT2i exposure at cisplatin initiation and matched 1:1 using inverse propensity scores based on baseline characteristics. Descriptive statistics summarized baseline and outcome variables; parametric or nonparametric tests assessed group differences. Logistic regression and analysis of variance were used for further outcome analyses. Results: with a median of 5 infusions, and median follow-up was 2 months. Incidence of AKI was lower in the SGLT2i group compared with controls (13.9% vs. 28.5%; odds ratio [OR]: 0.42; 95% confidence interval [CI]: 0.23-0.76). The SGLT2i group also showed higher mean estimated glomerular filtration rate (eGFR) at 3 months postcisplatin therapy, lower rate of hypomagnesemia, hyponatremia, and anemia than the control. Difference in hyponatremia was not statistically significant. Conclusion: Our findings suggest that continuation of SGLT2i may offer kidney-protective effects against AKI in patients with diabetes mellitus undergoing cisplatin chemotherapy. A well-designed randomized clinical trial is needed to validate this potential benefit.