Abstract: SA-PO0033
Unmasking the Silent Threat: Acute Kidney Disease in Patients with Head and Neck Cancer Receiving High-Dose Cisplatin
Session Information
- AKI: Novel Patient Populations and Case Reports
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Trevisani, Francesco, IRCCS Ospedale San Raffaele, Milan, Lombardy, Italy
- Cardellini, Sara, IRCCS Ospedale San Raffaele, Milan, Lombardy, Italy
- Monti, Agnese, IRCCS Ospedale San Raffaele, Milan, Lombardy, Italy
- Paccagnella, Matteo, Fondazione ARCO Cuneo, Cuneo, Italy
- Floris, Matteo, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
- Angioi, Andrea, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
- Mirabile, Aurora, IRCCS Ospedale San Raffaele, Milan, Lombardy, Italy
Background
Cisplatin-based chemoradiotherapy is a standard treatment for squamous cell carcinoma of the head and neck (SCCHN), but nephrotoxicity often leads to dose reductions or early discontinuation. Acute Kidney Disease (AKD) is an emerging concern in this setting, yet its incidence and risk factors remain poorly defined. This prospective, single-center study evaluated AKD incidence in SCCHN patients receiving cisplatin-based treatment.
Methods
We conducted a prospective cohort study of 207 adult patients with head and neck cancer treated with cisplatin-based chemotherapy between 2018 and 2024 at IRCCS San Raffaele. Serum creatinine and eGFR (CKD-EPI 2021) were measured before each chemotherapy cycle. AKD was defined according to KDIGO 2024 criteria. Continuous variables were tested for normality using the Shapiro–Wilk test and analyzed with non-parametric methods. Associations with AKD were assessed using univariate and multivariate logistic regression (OR, 95% CI). Statistical significance was set at p<0.05.
Results
Among 204 evaluable patients, 31 (15.2%) developed AKD. AKD occurred in 9.66% between the first and second cycle, and in 8.21% between the second and third. In univariate analysis, higher BMI (OR 1.11; p=0.01), older age (OR 1.05; p=0.02), weight (OR 1.02; p=0.04), hypertension (p=0.04), and diuretics (p=0.04) were significantly associated with AKD. In multivariate analysis, only age showed borderline significance (OR 1.04; p=0.06).
Conclusion
AKD developed in 15.2% of patients with SCCHN during cisplatin-based treatment. Age showed a borderline independent association with AKD, while other baseline variables were not statistically significant. These findings underscore the need for close renal monitoring and individualized risk assessment in oncologic patients undergoing nephrotoxic treatment.