Predictive Role of Neutrophil Gelatinase-Associated Lipocalin in Early Diagnosis of Platin-Induced Renal Injury

摘要

Background: Acute kidney injury is an important issue in chemotherapy receiving patients an neutrophilgelatinase-associated lipocalin has been proposed as a novel marker. We here aimed to assess the role of urinarylevels for assessment after platin exposure. Materials and Methods: Patients who had treated with cisplatin orcarboplatin or oxaliplatin containg regimens were included in this study. Baseline and postchemotherapy serumurea, creatinine, urine neutrophil gelatinase-associated lipocalin and urine creatinine levels were determined.To avoid the effects of hydration during chemotherapy infusion the urinary neutrophil gelatinase-associatedlipocalin/urine creatinine ratio was used to determine acute kidney injury. Results: Of a total of 42 patientsreceiving platin compounds,14 (33.3%) received cisplatin containing regimens, 14 (33.3%) received carboplatinand 14 (33.3%) oxaliplatin. The median age was 60 (37-76) years. Nineteen of the patients (45.2%) had lungcancer, 12 (28.6%) colorectal cancer and 11 (26.2%) others. The median pre and post chemotherapy urineneutrophil gelatinase-associated lipocalin/urine creatinin ratio was 15.6 ng/mg and 35.8 ng/mg (p=0.041) in thecisplatin group, 32.5 ng/mg and 86.3 ng/mg (p=0.004) in the carboplatin group and 40.9 ng/mg and 62.3 ng/mg (p=0.243) in the oxaliplatin group. Conclusions: Nephrotoxicity is a serious side effect of chemotherapeuticagentslike cisplatin and carbopaltin, but only to a lower extent oxaliplatin. All platin compounds must be usedcarefully and urine neutrophil gelatinase-associated lipocalin measurement seems to be promising in detectingacute kidney injury earlier than with creatinine.