Evaluation of serum cystatin C levels and 99mTechnetium-mercaptoacetyltriglycine-3 renal scintigraphy for the early detection of cisplatin-induced renal toxicity in cancer patients

• Published in: Nephrology (Carlton, Vic.) Vol. 7; no. 2; pp. 56 - 60
• Main Authors: GÜNEL, Nazan, COSKUN, Ugur, YAMAÇ, Deniz, ABAMOR, Evrim, DEMIRTAS, Selda, ATASEVER, Tamer, KARACA, Levent
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2002
• Subjects: 99mTechnetium-mercaptcacetyltriglycine-3 scintigraphy; cisplatin; cystatin C; nephrotoxicity
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1046/j.1440-1797.2002.00082.x

Cisplatin has a broad‐spectrum antineoplastic activity. Nephrotoxicity is a prominent component of the toxicity profile of cisplatin‐based chemotherapy. In recent years, several reports have confirmed that cystatin C (cys‐C) demonstrates a better correlation with the glomerular filtration rate than with serum creatinine. Scintigraphic techniques are also widely used in evaluating renal function. In the present study, serum cys‐C, serum creatinine concentrations and 99mTechnetium‐mercaptoacetyltriglycine‐3 (99mTc‐MAG‐3) scintigraphy were studied in 22 cisplatin‐naive cancer patients, 3 days before and 24 h after the first cycle of cisplatin‐based chemotherapy. Serum cystatin C and creatinine levels increased in cancer patients after chemotherapy (creatinine: from 68 ± 12 to 72 ± 17 nmol/L; cystatin‐C: from 0.064 ± 0.025 to 0.072 ± 0.033 jimol/L), but these differences were not statistically significant (P>0.05). Semiquantitative variables of 99mTc‐MAG‐S scintigraphy significantly elevated after chemotherapy (T½*: from 10.27 ± 5.00to 16.17 ± 9.40 min, R20/max*: from 0.40 ± 0.12 to 0.67+0.45, Tmax**: from 5.40 ± 4.01 to 7.59 ± 5.30 min; *P<0.001, **P<0.01, respectively). These results suggest that MAG‐3 scintigraphy is a highly sensitive method in the early detection of cisplatin‐induced nephrotoxicity. Serum cystatin C doesn't seem to play a role in the early detection of cisplatin‐induced nephrotoxicity. As a result, MAG‐3 scintigraphy may be used in selected patients who have a predisposition for renal toxicity.