Department of Internal Diseases and Oncological Chemotherapy, Faculty of Medicine in Katowice, Medical University of Silesia in Katowice, 40-027 Katowice, Poland.
Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medicine in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland.
Int J Mol Sci. 2024 Jan 16;25(2):1074. doi: 10.3390/ijms25021074.
Cisplatin is still a widely used anticancer drug characterized by significant nephrotoxicity. Acute kidney injury (AKI), diagnosed based on the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, has limitations, including a delayed increase in creatinine. We determined the usefulness of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) in diagnosing AKI according to the KDIGO criteria in patients treated with cisplatin. We recruited 21 subjects starting cisplatin-based chemotherapy (Cisplatin-based group) and 11 treated with carboplatin-based chemotherapy or 5-fluorouracil regimens (non-cisplatin-based group). Blood and urine samples were collected during four subsequent cycles of chemotherapy (68 and 38 cycles, respectively). AKI occurred in four patients in the cisplatin-based group (5.9% of 68 cisplatin-based chemotherapy cycles). Among them, three urinary markers were increased by over 100% in two cases, two in one case and one in another. A doubling of at least one investigated parameter was observed more frequently during cisplatin-based chemotherapy (80.3% vs. 52.8%; OR = 3.65, 95% CI: 1.49-8.90; < 0.01). The doubling of at least one new urinary AKI marker was more common in patients receiving cisplatin and frequently was not associated with overt AKI. Thus, a subclinical kidney injury detected by these markers occurs more frequently than deterioration in kidney function stated with creatinine changes.
顺铂仍然是一种广泛使用的抗癌药物，其特点是具有显著的肾毒性。根据肾脏病：改善全球预后（KDIGO）标准诊断的急性肾损伤（AKI）有其局限性，包括肌酐升高的延迟。我们确定中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、肾损伤分子-1（KIM-1）和白细胞介素-18（IL-18）在诊断顺铂治疗患者 AKI 中的作用，这些患者根据 KDIGO 标准接受顺铂为基础的化疗（顺铂组）或卡铂为基础的化疗或 5-氟尿嘧啶方案（非顺铂组）。在随后的四个化疗周期中采集血液和尿液样本（分别为 68 和 38 个周期）。顺铂组中有 4 例患者发生 AKI（5.9%的 68 个顺铂化疗周期）。其中，3 种尿标志物在 2 例中升高 100%以上，2 例中升高 100%以下，1 例中升高 50%以下。在顺铂组中，至少有一个检测参数翻倍的情况更常见（80.3% vs. 52.8%；OR=3.65，95%CI：1.49-8.90；<0.01）。在接受顺铂治疗的患者中，至少有一个新的尿 AKI 标志物翻倍的情况更常见，而且通常与明显的 AKI 无关。因此，这些标志物检测到的亚临床肾脏损伤比肌酐变化表明的肾功能恶化更为常见。
