Abstract: SA-PO1243
International Survey of Practice Patterns Regarding Prevention of Cisplatin-Associated AKI
Session Information
- Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Braga Barbosa, Gessica Sabrine, Universidade de Sao Paulo, Ribeirão Preto, SP, Brazil
- Kitchlu, Abhijat, University of Toronto, Toronto, Ontario, Canada
- Gupta, Shruti, Harvard Medical School, Boston, Massachusetts, United States
- Costa e Silva, Veronica Torres, Universidade de Sao Paulo, São Paulo, SP, Brazil
Background
Cisplatin-associated acute kidney injury (CP-AKI) is a common complication that may interrupt cancer treatment. Evidence supporting nephroprotective strategies is limited, resulting in substantial variation in clinical practice. We conducted an international survey to evaluate current approaches to CP-AKI prevention.
Methods
We developed an anonymous REDCap-based survey and distributed it internationally through email and professional networks to nephrologists and oncologists.
Results
By April 2026, 153 clinicians had responded, including 106 nephrologists (70%) and 46 oncologists (30%) across 16 countries (Figure). Most participants practiced at university-affiliated cancer centers or general hospitals and reported 11–20 years of clinical experience. In addition, 64% reported having institutional protocols for CP-AKI prevention. Hydration was included in nearly all protocols, while routine magnesium supplementation was used in approximately half. Mannitol was included in 1/4 of protocols. Thresholds for withholding cisplatin based on glomerular filtration thresholds varied widely. Other preventative measures included avoidance of NSAIDs, IV contrast, diuretics, and RAASi. Most respondents supported routine pre-treatment risk assessment for CP-AKI and post-treatment serum creatinine monitoring. Communication between oncology and nephrology teams regarding CP-AKI prevention was variable.
Conclusion
Preventive strategies for CP-AKI differ across centers, highlighting ongoing uncertainty in best practices. Magnesium supplementation remains underutilized, despite emerging evidence of benefit, while mannitol continues to be used in some centers despite emerging evidence suggesting a harmful effect. These findings underscore the need for standardized, evidence-based prevention protocols and improved collaboration between oncology and nephrology teams.