Open AccessPredicting Acute Renal Injury in Cancer Patients Receiving Cisplatin Using Urinary Neutrophil Gelatinase‐Associated Lipocalin and Cystatin C
Author(s) -
Jelinek Michael J.,
Lee Sang Mee,
Wyche Okpareke Alicia,
Wing Claudia,
Koyner Jay L.,
Murray Patrick T.,
Stadler Walter M.,
O’ Donnell Peter H.
Publication year - 2018
Publication title -
clinical and translational science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.303
H-Index - 44
eISSN - 1752-8062
pISSN - 1752-8054
DOI - 10.1111/cts.12547
Subject(s) - cisplatin , acute kidney injury , medicine , renal function , lipocalin , cystatin c , creatinine , urinary system , urology , chemotherapy , gastroenterology , oncology
Acute kidney injury (AKI) limits cisplatin use. We tested whether urine cystatin C (uCyC) and neutrophil gelatinase‐associated lipocalin (uNGAL) can preidentify patients at risk for AKI. Patients initiating cisplatin‐based chemotherapy were prospectively enrolled. uNGAL/uCyC were measured pre/post‐cisplatin administration and compared with serum creatinine (sCr). AKI was defined as sCr increase ≥50% or ≥0.3 mg/dL above baseline. In all, 102 patients were enrolled; 95 provided evaluable data. Twenty‐five patients developed AKI. Median baseline and pre‐cisplatin uNGAL levels were significantly higher in AKI patients. Although immediate changes in uNGAL/uCyC 2 h after cisplatin were not detectable, post‐cisplatin peak values over the course of therapy were markedly and significantly elevated in AKI patients. In multivariate modeling with age, baseline glomerular filtration rate, and histology, maximum uCyC was a significant independent AKI predictor. These findings suggest pre‐cisplatin uNGAL and peak uCyC levels can identify patients with increased AKI risk, potentially allowing for tailored modification of cisplatin‐based treatment regimens.