KIDNEY INJURY MOLCULE-1 AND HUMAN NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN AS NOVEL URINARY BIOMARKER FOR EARLY DETECTION OF PLATINUM BASED DRUGS INDUCED NEPHROTOXICITY: CLINICAL STUDY

Document Type : Original Article

Authors

1 forensic medicine and clinical toxicology departement, faculty of medicine zagazig university,Egypt

2 forensic medicine and clinical toxicology

3 clinical oncology faculty of medicine Zagazig University

4 clinical pathology faculty of medicine Zagazig University

5 internal medicine faculty of medicine Zagazig University

6 Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Abstract

Background The most severe side effect of platinum-based anticancer drugs is nephrotoxicity, which is the main barrier to using large dosage procedures to maximize the curative advantages. A common technique that temporarily serves as a biomarker for drug-induced acute nephrotoxic injury is serum creatinine levels. Objectives This research necessitates the search for new, precise biomarkers in those patients. Methodology Fifty nine patients getting platinum based drugs participated in a cross-sectional study. According to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines 2012, acute renal damage was detected by routinely testing serum creatinine levels. On the first day of therapy and for three days after the drugs` cycle, serum creatinine and the urine biomarkers (kidney injury molecule- and human neutrophil gelatinase-associated lipocalin) were assessed. Results Thirty nine patients (66.1% of patients) experienced nephrotoxicity. The previous urine biomarkers showed significant increase in samples collected. When compared to their baseline levels, all indicators have considerably increased in the third day (P < 0.001). The optimum previous urinary biomarkers` cutoffs for diagnosing platnium based drugs-induced nephrotoxicity are ≥1.345 with an area under curve of 0.87, 92.3% sensitivity, and 80 % specificity, & ≥418.95 with an area under curve of 0.772, 87.2% sensitivity, and 80 % specificity respectively. When compared to serum creatinine, urinary biomarkers are more accurate than serum creatinine at predicting nephrotoxicity caused by platinum based drugs. Conclusion The most accurate biomarker for platinum based drugs patients' early nephrotoxicity prediction is kidney injury molecule -1.

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