• Elliyeh Ghadrdan, Sholeh Ebrahimpour, Sanambar Sadighi, Samira Chaibakhsh, and Zahra Jahangard-Rafsanjani.
• Department of Clinical Pharmacy. Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
• J Oncol Pharm Pract. 2020 Oct 1; 26 (7): 1643-1649.

IntroductionCisplatin-associated acute kidney injury (AKI) is the major limitation to the use of cisplatin-based chemotherapy regimens. Serum creatinine as a traditional marker did not increase in a timely enough fashion in AKI patients. Therefore, recently, the novel markers such as neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) were considered for early detection of AKI. The aim of this study was to compare the sensitivity and specificity of urinary NGAL and KIM-1 with serum creatinine in cisplatin related AKI.MethodsPatients ≥18 years with solid tumors who received cisplatin-based chemotherapy were included. Urine samples were collected 0, 6 and 24 h after cisplatin infusion and the urinary NGAL, KIM-1, and creatinine concentrations were evaluated. NGAL and KIM-1 concentrations were adjusted based on urine creatinine to eliminate hydration effects. Serum creatinine levels were assessed at the base and 72 h after cisplatin administration.ResultsSeven out of the 35 recruited patients (20%) suffered from AKI defined by Acute Kidney Injury Network criteria. In AKI patients, the ratio of urinary KIM-1-creatinine at 24 h compared to baseline (24 h/baseline) and NGAL-creatinine 24 h/baseline were significantly higher than those of non-AKI group (p = 0.037 and 0.047 respectively). The area under the receiver-operating characteristic curve for KIM-1-creatinine 24 h/baseline and NGAL-creatinine 24 h/baseline were 0.78 (0.59-0.96, p = 0.032) and 0.77 (0.57-0.97, p = 0.036) respectively.ConclusionsOur findings showed that the changes in urinary NGAL-creatinine and KIM-1-creatinine ratios, 24 h after cisplatin administration can be utilized to predict AKI in cisplatin recipients.

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