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Incidence and physiological mechanism of carboplatin-induced electrolyte abnormality among patients with non-small cell lung cancer

View Article: PubMed Central - PubMed

ABSTRACT

To clarify the association between carboplatin and electrolyte abnormality, a pooled-analysis was performed with the adverse event reports of non-small cell lung cancer patients. A total of 19901 adverse events were retrieved from the FDA Adverse Event Reporting System (FAERS). Pooled reporting odds ratios (RORs) and 95% CIs suggested that carboplatin was significantly associated with hyponatremia (pooled ROR = 1.57, 95% CI 1.182.09, P = 1.99 × 10-3) and hypokalemia (pooled ROR = 2.37, 95% CI 1.803.10, P = 5.24 × 10-10) as compared to other therapies. In addition, we found that dehydration was frequently concurrent with carboplatin therapy (pooled ROR = 2.01, 95% CI 1.522.66, P = 8.37 × 10-7), which may prompt excessive water ingestion and decrease serum electrolyte concentrations. This information has not been mentioned in the FDA-approved drug label and could help explain the physiological mechanism of carboplatin-induced electrolyte abnormality. In conclusion, the above results will facilitate clinical management and prompt intervention of life-threatening electrolyte imbalance in the course of cancer treatment.

No MeSH data available.


Related in: MedlinePlus

Forest plot of fixed-effects (FE) meta-analysis on impaired renal function
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Figure 3: Forest plot of fixed-effects (FE) meta-analysis on impaired renal function

Mentions: The above analysis on adverse events demonstrated the risk of carboplatin-induced electrolyte imbalance, but may not explain the underlying physiological mechanism. It is widely recognized that electrolyte abnormality, as a disorder of water homeostasis, may develop most often with impaired capability of the kidney to excrete free water [20] or excessive intake of water [21]. Therefore, we further examined the effects of carboplatin on renal function and water ingestion. On one hand, a fixed-effects meta-analysis (χ2-based Q test P = 0.41, I2 = 3%) indicated a non-significant association between carboplatin and impaired renal function (Figure 3, pooled ROR = 1.17, 95% CI 0.69-1.96). On the other hand, a random-effects meta-analysis (χ2-based Q test P = 1.09×10-5, I2 = 74%) demonstrated that carboplatin was significantly associated with dehydration (Figure 4, pooled ROR = 2.01, 95% CI 1.52-2.66, P = 8.37×10-7). And no reporting bias was found with regard to such an association (Supplementary Figure 3, Egger's test P = 0.22). These results suggested that carboplatin-induced dehydration may trigger strong sensation of thirst and naturally prompt overdrinking. In consequence, the electrolytes in body will be diluted by excess water.


Incidence and physiological mechanism of carboplatin-induced electrolyte abnormality among patients with non-small cell lung cancer
Forest plot of fixed-effects (FE) meta-analysis on impaired renal function
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5392339&req=5

Figure 3: Forest plot of fixed-effects (FE) meta-analysis on impaired renal function
Mentions: The above analysis on adverse events demonstrated the risk of carboplatin-induced electrolyte imbalance, but may not explain the underlying physiological mechanism. It is widely recognized that electrolyte abnormality, as a disorder of water homeostasis, may develop most often with impaired capability of the kidney to excrete free water [20] or excessive intake of water [21]. Therefore, we further examined the effects of carboplatin on renal function and water ingestion. On one hand, a fixed-effects meta-analysis (χ2-based Q test P = 0.41, I2 = 3%) indicated a non-significant association between carboplatin and impaired renal function (Figure 3, pooled ROR = 1.17, 95% CI 0.69-1.96). On the other hand, a random-effects meta-analysis (χ2-based Q test P = 1.09×10-5, I2 = 74%) demonstrated that carboplatin was significantly associated with dehydration (Figure 4, pooled ROR = 2.01, 95% CI 1.52-2.66, P = 8.37×10-7). And no reporting bias was found with regard to such an association (Supplementary Figure 3, Egger's test P = 0.22). These results suggested that carboplatin-induced dehydration may trigger strong sensation of thirst and naturally prompt overdrinking. In consequence, the electrolytes in body will be diluted by excess water.

View Article: PubMed Central - PubMed

ABSTRACT

To clarify the association between carboplatin and electrolyte abnormality, a pooled-analysis was performed with the adverse event reports of non-small cell lung cancer patients. A total of 19901 adverse events were retrieved from the FDA Adverse Event Reporting System (FAERS). Pooled reporting odds ratios (RORs) and 95% CIs suggested that carboplatin was significantly associated with hyponatremia (pooled ROR = 1.57, 95% CI 1.182.09, P = 1.99 × 10-3) and hypokalemia (pooled ROR = 2.37, 95% CI 1.803.10, P = 5.24 × 10-10) as compared to other therapies. In addition, we found that dehydration was frequently concurrent with carboplatin therapy (pooled ROR = 2.01, 95% CI 1.522.66, P = 8.37 × 10-7), which may prompt excessive water ingestion and decrease serum electrolyte concentrations. This information has not been mentioned in the FDA-approved drug label and could help explain the physiological mechanism of carboplatin-induced electrolyte abnormality. In conclusion, the above results will facilitate clinical management and prompt intervention of life-threatening electrolyte imbalance in the course of cancer treatment.

No MeSH data available.


Related in: MedlinePlus