Abstract
Purpose
Acute kidney injury (AKI) is a common and serious adverse effect of cisplatin-based chemotherapy. However, traditional markers of kidney function, such as serum creatinine, are suboptimal, because they are not sensitive measures of proximal tubular injury. We aimed to determine whether the new urinary biomarkers such as kidney injury molecule-1 (KIM-1), monocyte chemotactic protein-1 (MCP-1), and neutrophil gelatinase-associated lipocalin (NGAL) could detect cisplatin-induced AKI in lung cancer patients in comparison with the conventional urinary proteins such as N-acetyl-β-d-glucosaminidase (NAG) and β2-microglobulin.
Methods
We measured KIM-1, MCP-1, NGAL, NAG, and β2-microglobulin concentrations in urine samples from 11 lung cancer patients, which were collected the day before cisplatin administration and on days 3, 7, and 14. Subsequently, we evaluated these biomarkers by comparing their concentrations in 30 AKI positive (+) and 12 AKI negative (−) samples and performing receiver operating characteristic (ROC) curve analyses.
Results
The urinary levels normalized with urine creatinine of KIM-1 and MCP-1, but not NGAL, NAG, and β2-microglobulin in AKI (+) samples were significantly higher than those in AKI (−) samples. In addition, ROC curve analyses revealed that KIM-1 and MCP-1, but not NGAL, could detect AKI with high accuracy (area under the curve [AUC] = 0.858, 0.850, and 0.608, respectively). The combination of KIM-1 and MCP-1 outperformed either biomarker alone (AUC = 0.871).
Conclusions
Urinary KIM-1 and MCP-1, either alone or in combination, may represent biomarkers of cisplatin-induced AKI in lung cancer patients.
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Abbreviations
- AKI:
-
Acute kidney injury
- KIM-1:
-
Kidney injury molecule-1
- MCP-1:
-
Monocyte chemotactic protein-1
- NGAL:
-
Neutrophil gelatinase-associated lipocalin
- AUC-ROC:
-
Area under the receiver operating characteristic curve
- Scr:
-
Serum creatinine
- BUN:
-
Blood urea nitrogen
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Acknowledgments
This work was supported in part by a Grant-in-Aid for Scientific Research (KAKENHI) from the Ministry of Education, Science, Culture, Sports, and Technology of Japan (MEXT); a Grant-in-Aid for Research on Biological Markers for New Drug Development and Health and Labour Sciences Research Grants from the Ministry of Health, Labour, and Welfare of Japan (08062855); and a funding program for Next Generation World-Leading Researchers (LS073 to SM) from the Council for Science and Technology Policy of the Japan Society for the Promotion of Science.
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Shinke, H., Masuda, S., Togashi, Y. et al. Urinary kidney injury molecule-1 and monocyte chemotactic protein-1 are noninvasive biomarkers of cisplatin-induced nephrotoxicity in lung cancer patients. Cancer Chemother Pharmacol 76, 989–996 (2015). https://doi.org/10.1007/s00280-015-2880-y
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DOI: https://doi.org/10.1007/s00280-015-2880-y