A systematic review for prevention of cisplatin-induced nephrotoxicity using different hydration protocols and meta-analysis for magnesium hydrate supplementation

Clin Exp Nephrol. 2024 Jan;28(1):1-12. doi: 10.1007/s10157-023-02386-2. Epub 2023 Aug 2.

Abstract

Background: Nephrotoxicity remains the most serious side effect of cisplatin therapy. Cisplatin-induced nephrotoxicity (CIN) limits the use of this drug and affects up to 20% of patients. Several possible interventions such as magnesium supplementation may prevent CIN. This study aimed to review different types of hydration protocols and we conducted a meta-analysis of magnesium supplementation to understand its effect in protecting against CIN.

Methods: A search of the PubMed, Embase, and Cochrane databases was performed. Trials were eligible if they enrolled patients who received cisplatin and different hydration protocols to prevent CIN. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the efficacy of different protocols.

Results: We initially identified 1113 different studies and included 33 of them which met the selection criteria. A meta-analysis of 11 retrospective studies that examined magnesium supplementation during hydration showed that this treatment provided significant protection against CIN (OR = 0.22, 95% CI = 0.14 to 0.35).

Conclusion: There has been uncertainty regarding the best method to prevent CIN. Our results highlight the potentially protective effect of magnesium supplementation during hydration. This study is registered in PROSPERO, CRD42020212682.

Keywords: Cisplatin; Hydration; Nephrotoxicity.

Publication types

  • Review

MeSH terms

  • Cisplatin* / adverse effects
  • Dietary Supplements
  • Humans
  • Magnesium / therapeutic use
  • Magnesium Hydroxide
  • Meta-Analysis as Topic
  • Renal Insufficiency* / chemically induced
  • Retrospective Studies
  • Systematic Reviews as Topic

Substances

  • Cisplatin
  • Magnesium Hydroxide
  • Magnesium