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Prognostic significance of hyponatremia induced by systemic chemotherapy in a hospital-based propensity score-matched analysis

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Abstract

Background

During chemotherapy, hyponatremia is one of the most frequently encountered adverse effects. This study aimed to investigate the prognostic impact of hyponatremia induced by systemic chemotherapy (HIC) using a propensity matching method in cumulative pooled data.

Methods

Between January 2011 and July 2017, 2129 patients were administered systemic chemotherapy for malignancy in various organs at Nagoya City University Hospital. Patients were divided into two groups: a grade 0–1 group (control group) and a grade 3–4 group (severe group) according to the severity of HIC appearing within 30 days after starting treatment. Kaplan–Meier curves were used for survival and recurrence analyses using a propensity case-matched analysis.

Result

The number of severe HIC patients was 93 (4.4%). In platinum-containing regimens, HIC appeared at higher frequencies. In the 21.2 months median follow-up period, the median OS (mOS) in the severe group was 49.1 months, which was significantly worse than the mOS in the control group; the OS in the control group did not reach the median. Univariate and multivariate analyses of associated factors in patients with grade 3–4 HIC revealed that renal dysfunction, cisplatin-containing regimen, and infusion of more than 5000 mL fluid was associated with HIC.

Conclusion

This study suggests that severe HIC in the first treatment cycle affects survival time. Chemotherapy patients receiving extensive hydration should be required to undergo frequent monitoring of serum sodium levels, especially patients receiving platinum-containing regimens.

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Acknowledgements

This work was supported in part by a Grant-Aid from the Ministry of Education, Culture, Sports Science and Technology of Japan [Grant number 18K 16456].

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Authors and Affiliations

  1. Department of Pharmacy, Nagoya City University Hospital, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Yosuke Sugiyama, Yoshihiko Tasaki, Yuki Kondo & Kazunori Kimura

  2. Department of Clinical Pharmaceutics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan

    Yosuke Sugiyama, Yoshihiko Tasaki, Tomoya Kataoka & Kazunori Kimura

  3. Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan

    Taku Naiki, Toshiki Etani, Keitaro Iida, Satoshi Nozaki, Ryosuke Ando & Takahiro Yasui

  4. Clinical Research Management Center, Nagoya City University Hospital, Nagoya, Japan

    Satoshi Osaga

Authors
  1. Yosuke Sugiyama
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  2. Taku Naiki
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  3. Yoshihiko Tasaki
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  4. Yuki Kondo
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  5. Tomoya Kataoka
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  6. Toshiki Etani
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  7. Keitaro Iida
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  8. Satoshi Nozaki
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  9. Ryosuke Ando
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  10. Satoshi Osaga
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  11. Takahiro Yasui
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  12. Kazunori Kimura
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Corresponding author

Correspondence to Kazunori Kimura.

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Conflict of interest

All authors declare no conflict of interest.

Ethical approval

This study was approved by the Ethics Committee of Nagoya City University Hospital, and written informed consent from patients was waived because of the retrospective design (Approval no. 60160132). In addition, histopathological evaluation and participation in this study was performed retrospectively with opt-out consent for the reuse of previously obtained specimens for routine pathological diagnosis. This study was conducted in accordance with the Declaration of Helsinki (according to the 2013 Fortaleza revision).

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Cite this article

Sugiyama, Y., Naiki, T., Tasaki, Y. et al. Prognostic significance of hyponatremia induced by systemic chemotherapy in a hospital-based propensity score-matched analysis. Int J Clin Oncol 25, 541–551 (2020). https://doi.org/10.1007/s10147-019-01579-8

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  • DOI: https://doi.org/10.1007/s10147-019-01579-8

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