Gonadotropin-releasing hormone agonists and acute kidney injury in patients with prostate cancer. By Gandaglia et al. 2014
Key sentence from the paper: “ADT is associated with an increased risk of [acute kidney injury] in patients with nonmetastatic [prostate cancer].”
For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/24495466
Commentary: This is yet another paper from the SEER database. Here the authors looked at data collected between 1995 and 2009 on 69,292 patients diagnosed with non-metastatic prostate cancer. What they found is surprising in a few ways.
Just as we were finishing the book, Androgen Deprivation Therapy: An Essential Guide for Prostate Cancer Patients and their Loved Ones, some information came out suggesting that ADT could be dangerous to the kidneys. This paper by Gandaglia et al. confirms that finding. In fact, this paper shows that as many as one in 16 individuals exposed to LHRH agonist drugs are likely to develop acute kidney injury. The authors also suggested that chronic kidney disease may also be exacerbated by these drugs.
What is most surprising though is that androgen deprivation achieved with an orchiectomy does not appear to have the same risk. In a paper by the same group, which we dedicated a blog entry to (dated May 5, 2014), it was suggested that ADT achieved with an orchiectomy also has a lower cardiovascular risk than ADT achieved with LHRH (luteinizing hormone releasing hormone) agonist drugs, like Lupron and Zoladex. Both reports suggest that the hormone LHRH has certain roles in the body that go beyond just controlling the production of testosterone. Indeed receptors for LHRH exist in a variety of bodily tissues.
Gandaglia, G., Sun, M., Hu, J.C., Novara, G., Choueiri, T.K., Nguyen, P.L., Schiffmann, J., Graefen, M., Shariat, S.F., Abdollah, F., Briganti, A., Montorsi, F., Trinh, Q.D., Karakiewicz, P.I., 2014. Gonadotropin-releasing hormone agonists and acute kidney injury in patients with prostate cancer. European Urology. 66, 1125-32.