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Open Access 01-12-2018 | Research article

Urinary biomarkers for early detection of platinum based drugs induced nephrotoxicity

Authors: Mostafa Abdelsalam, Ekramy Elmorsy, Hassan Abdelwahab, Osman Algohary, Mahmoud Naguib, Ahmed Abd El Wahab, Ahmed Eldeeb, Ehab Eltoraby, Adel Abdelsalam, Alaa Sabry, Mohamed El-Metwally, Mohamed Akl, Nahla Anber, Maysaa El Sayed Zaki, Fahad Almutairi, Tamer Mansour

Published in: BMC Nephrology | Issue 1/2018

Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.

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Title: Urinary biomarkers for early detection of platinum based drugs induced nephrotoxicity
Authors: Mostafa Abdelsalam
Ekramy Elmorsy
Hassan Abdelwahab
Osman Algohary
Mahmoud Naguib
Ahmed Abd El Wahab
Ahmed Eldeeb
Ehab Eltoraby
Adel Abdelsalam
Alaa Sabry
Mohamed El-Metwally
Mohamed Akl
Nahla Anber
Maysaa El Sayed Zaki
Fahad Almutairi
Tamer Mansour
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Nephrology / Issue 1/2018
Electronic ISSN: 1471-2369
DOI: https://doi.org/10.1186/s12882-018-1022-2

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