Thana PatimarattanananArkom NongnuchPoompis PattaranutapornNattawut UnwanathamChuleeporn JiarpinitnunNuttapong NgamphaiboonFaculty of Medicine, Ramathibodi Hospital, Mahidol University2020-08-252020-08-252020-01-01Supportive Care in Cancer. (2020)14337339094143552-s2.0-85086360197https://repository.li.mahidol.ac.th/handle/20.500.14594/58262© 2020, Springer-Verlag GmbH Germany, part of Springer Nature. Background: An incidence of cisplatin-induced acute kidney injury (AKI) of 34% has been reported in patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC). However, delayed cisplatin-induced nephrotoxicity and long-term renal outcomes remain poorly studied. Methods: Patients with LA-HNSCC who underwent definitive or postoperative cisplatin-based chemoradiotherapy (CRT) were included. Acute kidney disease (AKD) was defined as newly developed estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 for < 3 months, ≥ 35% decrease in eGFR, or > 50% increase in serum creatinine for <3 months from baseline. Results: A total of 509 patients were analyzed. AKD and AKI occurred in 27.9% and 13.4% of patients, respectively. Most patients had primary prophylactic feeding tube (95%) and definitive CRT (83%). More AKD patients had an ECOG status of 0 (p = 0.017), diabetes (p = 0.044), and hypertension (p < 0.001). AKI, but not AKD, was significantly associated with cumulative cisplatin dose, delay, dose reduction, termination, and hospitalization during CRT. GFR percentage in patients with AKD declined significantly during CRT (− 36%), worsened at 3 months (− 39%), and had not recovered to baseline at 12 months after CRT (− 29%). Multivariate analysis identified ECOG status 0 and hypertension as significantly associated with the development of AKD. Conclusion: Almost one third of LA-HNSCC patients who underwent CRT with cisplatin developed AKD, and their eGFR did not recover to baseline even after 1 year. ECOG 0 and hypertension were associated with AKD. These findings may have been due to the physician’s awareness of AKD and underestimation of its potential complications in fit patients.Mahidol UniversityMedicineArticleSCOPUS10.1007/s00520-020-05566-y