Multicenter retrospective cohort study of impact of intravenous magnesium administration of cisplatin-associated acute kidney injury

Cisplatin-associated acute kidney injury (CP-AKI) is a frequent complication of cisplatin chemotherapy and is associated with considerable morbidity and mortality. In animal modes, prophylactic administration of intravenous (IV) magnesium attenuates CP-AKI. A retrospective study at 5 US centers investigated the impact of intravenous magnesium administration, at the first day of cisplatin chemotherapy, on CP-AKI. In this cohort study of 13,719 adults treated with a first dose of IV cisplatin between 2006 and 2022, receipt of IV magnesium was associated with a 20% lower adjusted odds of developing CP-AKI compared to those not receiving magnesium. These findings were supported by the results of multiple sensitivity and secondary analyses. The authors conclude that these findings indicate that prophylactic IV magnesium administration was associated with reduced CP-AKI incidence. This conclusion should be comfirmed in randomized clinical trials.