Motwani et al developed a score for predicting acute kidney injury (AKI) after the first course of cisplatin. This can help to identify a patient who may require more aggressive management. The authors are from Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Network Medicine Boston and Washington University in St. Louis.
Patient selection: first course of cisplatin, adult 18 to 90 years of age
Outcome: acute kidney injury (>=0.3 mg/dL rise in serum creatinine within 14 days of receiving cisplatin)
Frequency of outcome: 11-14%
Parameters:
(1) age in years
(2) serum albumin in g/dL
(3) cisplatin dose in mg
(4) hypertension
Parameter
Finding
Points
age in years
<= 60 years
0
61 to 70 years
1.5
71 to 90 years
2.5
serum albumin
> 3.5 g/dL
0
1.3 to 3.5 g/dL
2
cisplatin dose
<= 100 mg
0
101 to 150 mg
1
> 150 mg
3
hypertension
absent
0
present
2
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9.5
• The higher the score the greater the risk of AKI
Total Score
Development Cohort
Validation Cohort
0 to 3
4%
8%
3.5 to 6.0
14%
15%
6.5 to 9.5
39%
28%
Performance:
• The area under the ROC curve was 0.70 (validation) to 0.72 (development).
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