Hui Li1, Qiong Xu2, Yang Wang3, Kailan Chen1, Jianxin Li1. 1. Department of Hematology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China. 2. Department of Clinical Pharmacology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Jiangan District, Wuhan, 430016, Hubei, China. polarisyxt@hotmail.com. 3. Department of Clinical Pharmacology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, 100 Xianggang Road, Jiangan District, Wuhan, 430016, Hubei, China.
Abstract
PURPOSE: The present study was aimed at assessing the value of serum NGAL in identifying early acute kidney injury induced by HDMTX. METHODS: Children aged 1-14 years with newly diagnosed ALL receiving MTX over 3 g/m2 were enrolled. Serum NGAL concentrations, serum creatinine (Scr) and MTX concentrations were measured. The area under the receiver-operating characteristic curve (ROC) was used for evaluating variables' ability of early diagnosis of AKI. RESULTS: A total of 196 courses of 62 patients were assessed, and 22 courses (11.2%) developed AKI. Twenty-four hours serum NGAL concentrations, 24 h Scr ratio, 48 h Scr ratio, CMTX24 h, CMTX48 h, CMTX72 h were significantly higher in patients with AKI. The combination of 24 h Scr ratio and 24 h serum NGAL had higher value for detecting HDMTX induced AKI compared with the 24 h Scr ratio. And the combination had similar value for detecting HDMTX induced AKI compared with the 48 h Scr ratio. After 48 h, CMTX48 h had a satisfying accuracy in predicting AKI. The proportion of post-HDMTX sepsis in patients with AKI was significantly higher than that in patients without AKI. CONCLUSIONS: Serum NGAL levels could be used as a marker in identifying the direct kidney tubular damage induced by HDMTX. The combination of 24 h Scr ratio and 24 h serum NGAL had higher value for early diagnosis of HDMTX associated AKI compared with the 24 h Scr ratio.
PURPOSE: The present study was aimed at assessing the value of serum NGAL in identifying early acute kidney injury induced by HDMTX. METHODS:Children aged 1-14 years with newly diagnosed ALL receiving MTX over 3 g/m2 were enrolled. Serum NGAL concentrations, serum creatinine (Scr) and MTX concentrations were measured. The area under the receiver-operating characteristic curve (ROC) was used for evaluating variables' ability of early diagnosis of AKI. RESULTS: A total of 196 courses of 62 patients were assessed, and 22 courses (11.2%) developed AKI. Twenty-four hours serum NGAL concentrations, 24 h Scr ratio, 48 h Scr ratio, CMTX24 h, CMTX48 h, CMTX72 h were significantly higher in patients with AKI. The combination of 24 h Scr ratio and 24 h serum NGAL had higher value for detecting HDMTX induced AKI compared with the 24 h Scr ratio. And the combination had similar value for detecting HDMTX induced AKI compared with the 48 h Scr ratio. After 48 h, CMTX48 h had a satisfying accuracy in predicting AKI. The proportion of post-HDMTX sepsis in patients with AKI was significantly higher than that in patients without AKI. CONCLUSIONS: Serum NGAL levels could be used as a marker in identifying the direct kidney tubular damage induced by HDMTX. The combination of 24 h Scr ratio and 24 h serum NGAL had higher value for early diagnosis of HDMTX associated AKI compared with the 24 h Scr ratio.
Authors: Eryk Latoch; Katarzyna Konończuk; Katarzyna Taranta-Janusz; Katarzyna Muszyńska-Rosłan; Edyta Szymczak; Anna Wasilewska; Maryna Krawczuk-Rybak Journal: Cancer Chemother Pharmacol Date: 2020-10-14 Impact factor: 3.333