Urinary biomarkers for early detection of platinum based drugs induced nephrotoxicity

• Published in: BMC nephrology Vol. 19; no. 1; pp. 219 - 8
• Main Authors: Abdelsalam, Mostafa, Elmorsy, Ekramy, Abdelwahab, Hassan, Algohary, Osman, Naguib, Mahmoud, El Wahab, Ahmed Abd, Eldeeb, Ahmed, Eltoraby, Ehab, Abdelsalam, Adel, Sabry, Alaa, El-Metwally, Mohamed, Akl, Mohamed, Anber, Nahla, El Sayed Zaki, Maysaa, Almutairi, Fahad, Mansour, Tamer
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.09.2018; BioMed Central; BMC
• Subjects: Acute Kidney Injury - chemically induced; Acute Kidney Injury - diagnosis; Acute Kidney Injury - urine; Adult; Biological markers; Biomarkers; Biomarkers - urine; Cancer therapies; Care and treatment; Chemotherapy; Cisplatin; Cohort Studies; Complications and side effects; Creatinine; Cystatin C; Cystatin C - urine; Drug dosages; Drugs; Female; Health aspects; Hepatitis A Virus Cellular Receptor 1 - metabolism; Hospitals; Humans; Injuries; Kidney diseases; Kidneys; Lipocalin-2 - urine; Male; Middle Aged; Nephrology; Nephrotoxicity; Neutrophils; Ovarian cancer; Oxaplatin; Patient outcomes; Patients; Physiological aspects; Platinum; Platinum based drugs; Platinum Compounds - toxicity; Prospective Studies; Studies; Transplants & implants; Urinary biomarkers; United States; Egypt; Platinum based drugs; Oxaplatin; Urinary biomarkers; Nephrotoxicity; Cisplatin
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/s12882-018-1022-2

Nephrotoxicity is a major hazard complicating the use of platinum based drugs (PBD), which can hinder using higher doses protocols to maximize the therapeutic gain. Shortage of serum creatinine level as an accurate biomarker for acute kidney injuries (AKI) necessitates searching for novel biomarkers with better sensitivity and specificity in patients on PBD. In a prospective cohort design, 132 patients receiving PBD were selected for the study. AKI was diagnosed by continuous follow up of serum creatinine level according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines 2012. Serum creatinine and urinary biomarkers (KIM-1, NGAL and cystatin C) was measured in the day of treatment and for 3 days after PBD cycle. AKI occurred in 35 patients (26.52% of patients). KIM-1, Cystatin C, and NGAL showed significant increase in samples collected in the day of AKI in comparison to their corresponding basal levels (P <  0.0001). In addition, significant increase in urinary levels of the biomarkers in samples collected 1 day before AKI in comparison to their basal levels (P <  0.0001, P <  0.0001, and P = 0.013 for KIM-1, NGAL and Cystatin C respectively). Furthermore KIM-1 data showed a significant increase 2 days before serum creatinine rise in comparison to the corresponding KIM-1 levels in patients who developed AKI (P = 0.001). Urinary KIM-1, Cystatin C and NGAL can predict PBD induced AKI in earlier stages than serum createnine. KIM-1 is the most sensitive biomarker for early detection of AKI in patients receiving PBD.