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Abdelsalam M, Elmorsy E, Abdelwahab H, Algohary O, Naguib M, El Wahab AA, Eldeeb A, Eltoraby E, Abdelsalam A, Sabry A, El-Metwally M, Akl M, Anber N, El Sayed Zaki M, Almutairi F, Mansour T. Urinary biomarkers for early detection of platinum based drugs induced nephrotoxicity. BMC Nephrol 2018; 19:219. [PMID: 30180818 PMCID: PMC6123931 DOI: 10.1186/s12882-018-1022-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/28/2018] [Indexed: 11/10/2022] Open
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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Affiliation(s)
- Mostafa Abdelsalam
- Mansoura Nephrology and dialysis Unit, Internal Medicine Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ekramy Elmorsy
- Department of Forensic Medicine and Clinical Toxicology, Mansoura faculty of Medicine, Mansoura, Egypt
| | - Hassan Abdelwahab
- Mansoura Nephrology and dialysis Unit, Internal Medicine Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Osman Algohary
- Mansoura Nephrology and dialysis Unit, Internal Medicine Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mahmoud Naguib
- Mansoura Nephrology and dialysis Unit, Internal Medicine Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Abd El Wahab
- Mansoura Nephrology and dialysis Unit, Internal Medicine Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Eldeeb
- Mansoura Nephrology and dialysis Unit, Internal Medicine Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ehab Eltoraby
- Internal Medicine Departments, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Adel Abdelsalam
- Internal Medicine Departments, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Alaa Sabry
- Mansoura Nephrology and dialysis Unit, Internal Medicine Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed El-Metwally
- Internal Medicine Departments, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed Akl
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Nahla Anber
- Fellow of Biochemistry, Emergency Hospital, Mansoura University, Mansoura, Egypt
| | | | - Fahad Almutairi
- Department of Biochemistry, Faculty of Science, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
| | - Tamer Mansour
- Clinical Pathology Department, Mansoura faculty of Medicine, Mansoura, Egypt
- Department of Population Health and Reproduction, University of California, Davis, California, USA
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