Purpose Cisplatin-associated acute kidney injury (C-AKI) is common. We sought to develop and validate a predictive model for C-AKI after the first course of cisplatin. Methods Clinical and demographic data were collected on patients who received cisplatin between 2000 and 2016 at two cancer centers. C-AKI was defined as a 0.3 mg/dL rise in serum creatinine within 14 days of receiving cisplatin. Using multivariable logistic regression models with C-AKI as the primary outcome, we created a scoring model from the development cohort (DC) and tested it in the validation cohort (VC). Results C-AKI occurred in 13.6% of 2,118 patients in the DC and in 11.6% of 2,363 patients in the VC. Factors significantly associated with C-AKI included age 61 to 70 years (odds ratio [OR], 1.64 [95% CI, 1.21 to 2.23]; P = .001) and 71 to 90 years (OR, 2.97 [95% CI, 2.06 to 4.28]; P < .001) compared with ≤ 60 years; cisplatin dose 101 to 150 mg (OR, 1.58 [95% CI, 1.14 to 2.19]; P = .007) and > 150 mg (OR, 3.73 [95% CI, 2.68 to 5.20]; P < .001) compared with ≤ 100 mg; a history of hypertension (OR, 2.10 [95% CI, 1.54 to 2.72]; P < .001) compared with no hypertension; and serum albumin 2.0 to 3.5 g/dL (OR, 2.21 [95% CI, 1.62 to 3.03]; P < .001) compared with > 3.5 g/dL. The baseline estimated glomerular filtration rate was not significantly associated with the risk of C-AKI. The c-statistics of the score-based model in the DC and the VC were 0.72 (95% CI, 0.69 to 0.75) and 0.70 (95% CI, 0.67 to 0.73), respectively. Scores of 0, 3.5, and 8.5 were associated with a probability of C-AKI of 0.03 (95% CI, 0.03 to 0.05), 0.12 (95% CI, 0.11 to 0.14), and 0.51 (95% CI, 0.43 to 0.60), respectively. Conclusion A score-based model created by using the patient's age, cisplatin dose, hypertension, and serum albumin is predictive of C-AKI.

中文翻译：

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顺铂第一个疗程后急性肾损伤风险预测模型的建立和验证

目的顺铂相关的急性肾损伤 (C-AKI) 很常见。我们试图在第一个疗程的顺铂后开发和验证 C-AKI 的预测模型。方法 收集 2000 年至 2016 年在两个癌症中心接受顺铂治疗的患者的临床和人口统计学数据。C-AKI 定义为接受顺铂后 14 天内血清肌酐升高 0.3 mg/dL。使用以 C-AKI 作为主要结果的多变量逻辑回归模型，我们从发育队列 (DC) 创建了一个评分模型，并在验证队列 (VC) 中对其进行了测试。结果 DC 中 2,118 名患者中有 13.6% 发生 C-AKI，VC 中 2,363 名患者中有 11.6% 发生 C-AKI。与 C-AKI 显着相关的因素包括 61 至 70 岁（优势比 [OR]，1.64 [95% CI，1.21 至 2.23]；P = .001）和 71 至 90 岁（OR，2.97 [95% CI， 2. 06 至 4.28]；P < .001) 与 ≤ 60 岁相比；顺铂剂量 101 至 150 mg（OR，1.58 [95% CI，1.14 至 2.19]；P = .007）和 > 150 mg（OR，3.73 [95% CI，2.68 至 5.20]；P < .001） ≤ 100 毫克；与无高血压病史相比，有高血压病史（OR，2.10 [95% CI，1.54 至 2.72]；P < .001）；和血清白蛋白 2.0 至 3.5 g/dL（OR，2.21 [95% CI，1.62 至 3.03]；P < .001）与 > 3.5 g/dL。基线估计的肾小球滤过率与 C-AKI 的风险没有显着相关性。DC 和 VC 中基于分数的模型的 c 统计量分别为 0.72（95% CI，0.69 至 0.75）和 ​​0.70（95% CI，0.67 至 0.73）。0、3.5 和 8.5 的分数与 0.03（95% CI，0.03 至 0.05）、0.12（95% CI，0.11 至 0.14）和 0.51（95% CI，0.43 至 0.6）的 C-AKI 概率相关。 ）， 分别。