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Abstract: TH-PO066

Prevention of Cisplatin-Induced AKI by Magnesium Supplementation: A Systematic Review and Meta-Analysis

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Hamroun, Aghiles, Lille University Hospital Center, Lille, France
  • Lenain, Remi, Lille University Hospital Center, Lille, France
  • Bigna, Jean joel R., University of Paris Saclay, Paris, France
  • Maanaoui, Mehdi, Lille University Hospital Center, Lille, France
  • Bui, Linh, Lille University Hospital Center, Lille, France
  • Chamley, Paul, Lille University Hospital Center, Lille, France
  • Glowacki, Francois, Lille University Hospital Center, Lille, France
Background

Cisplatin-induced AKI (CIA) is a serious adverse event that affects 30-40% of exposed patients. To date, no prevention method has demonstrated its indisputable effectiveness.
Nevertheless, magnesium appears to play a nephroprotective role, partly through its action on the Organic Cation Transporter 2 (OCT2), a renal proximal tubular receptor.
The aim of this work is therefore to study the potential nephroprotective effect of magnesium supplementation on CIA.

Methods

After a systematic review on Pubmed, Embase and Web of Science, from January 1978 to January 2018, without language restriction, we performed a meta-analysis with a random effect model.
Primary outcome was the occurrence of a CIA, according AKI-KDIGO classification and grading (2012). Heterogeneity between studies was quantified (I2) and the analysis completed by a meta-regression to adjust the results for potential confounders.
This study is registered in the PROSPERO International Prospective Register of systematic reviews, registration number CRD42018090612.

Results

Within the 1125 eligible records, 15 studies fulfilling the selection criteria were included in this work (4 prospective and 11 retrospective cohort studies), for a total of 1841 patients.
The meta-analysis showed a significant nephroprotective effect of magnesium supplementation on grade 2 (OR=0.22, 95% CI 0.14-0.33, I2=0.0%), grade 3 (OR=0.25, 95% CI 0,08-0.76, I2=0.0%) and all combined grades of CIA (OR=0.24, 95% CI 0.19-0.32, I2=0.0%). This effect remained after adjustment for all potential confounding factors (sex, age, cumulative dose of Cisplatin, baseline renal function, performance status index, type of cancer, stage of disease and type of comolecule).

Conclusion

Today, relatively unknown, magnesium supplementation could become, in the future, an effective method of low-cost prevention for CIA.
In any case, these promising results encourage the implementation of a large-scale randomized trial.