Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based Chemotherapy
Background/Aims: Plasma cystatin C (pCysC) may be superior to serum creatinine (sCr) as a surrogate of GFR. However, the performance of pCysC for diagnosing acute kidney injury (AKI) after cisplatin-based chemotherapy is potentially affected by accompanying corticosteroid anti-emetic therapy and hyd...
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doaj-0a8c0cbdec8e4a00955a66c6c739bbbb2020-11-25T03:45:06ZengKarger PublishersKidney & Blood Pressure Research1420-40961423-01432017-03-01421627510.1159/000469715469715Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based ChemotherapyTimothy J. PiantaJohn W. PickeringLena SuccarMelvin ChinTrent DavidsonNicholas A. BuckleyFahim MohamedZoltan H. EndreBackground/Aims: Plasma cystatin C (pCysC) may be superior to serum creatinine (sCr) as a surrogate of GFR. However, the performance of pCysC for diagnosing acute kidney injury (AKI) after cisplatin-based chemotherapy is potentially affected by accompanying corticosteroid anti-emetic therapy and hydration. Methods: In a prospective observational study pCysC, sCr, urinary kidney injury molecule-1 (KIM-1), and urinary clusterin were measured over 2 weeks in 27 patients given first-cycle chemotherapy. The same variables were measured over 2 weeks in Sprague–Dawley rats given a single intraperitoneal injection of dexamethasone, cisplatin, or both, and in controls. Results: In patients, pCysC increases were greater than sCr 41% vs. 16%, mean paired difference 25% (95% CI: 16–34%)], relative increases were ≥ 50% in 9 patients (35%) for pCysC compared with 2 (8%) for sCr (p = 0.04) and increases in sCr were accompanied by increased KIM-1 and clusterin excretion, but increases in pCysC alone were not. In rats, dexamethasone administration produced dose-dependent increases in pCysC (and augmented cisplatin-induced increases in pCysC), but did not augment histological injury, increases in sCr, or KIM-1 and clusterin excretion. Conclusions: In the presence of dexamethasone, elevation of pCysC does not reliably diagnose AKI after cisplatin-based chemotherapy.http://www.karger.com/Article/FullText/469715Cystatin CCreatinineAcute kidney injuryBiomarkersDexamethasone |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Timothy J. Pianta John W. Pickering Lena Succar Melvin Chin Trent Davidson Nicholas A. Buckley Fahim Mohamed Zoltan H. Endre |
spellingShingle |
Timothy J. Pianta John W. Pickering Lena Succar Melvin Chin Trent Davidson Nicholas A. Buckley Fahim Mohamed Zoltan H. Endre Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based Chemotherapy Kidney & Blood Pressure Research Cystatin C Creatinine Acute kidney injury Biomarkers Dexamethasone |
author_facet |
Timothy J. Pianta John W. Pickering Lena Succar Melvin Chin Trent Davidson Nicholas A. Buckley Fahim Mohamed Zoltan H. Endre |
author_sort |
Timothy J. Pianta |
title |
Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based Chemotherapy |
title_short |
Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based Chemotherapy |
title_full |
Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based Chemotherapy |
title_fullStr |
Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based Chemotherapy |
title_full_unstemmed |
Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based Chemotherapy |
title_sort |
dexamethasone modifies cystatin c-based diagnosis of acute kidney injury during cisplatin-based chemotherapy |
publisher |
Karger Publishers |
series |
Kidney & Blood Pressure Research |
issn |
1420-4096 1423-0143 |
publishDate |
2017-03-01 |
description |
Background/Aims: Plasma cystatin C (pCysC) may be superior to serum creatinine (sCr) as a surrogate of GFR. However, the performance of pCysC for diagnosing acute kidney injury (AKI) after cisplatin-based chemotherapy is potentially affected by accompanying corticosteroid anti-emetic therapy and hydration. Methods: In a prospective observational study pCysC, sCr, urinary kidney injury molecule-1 (KIM-1), and urinary clusterin were measured over 2 weeks in 27 patients given first-cycle chemotherapy. The same variables were measured over 2 weeks in Sprague–Dawley rats given a single intraperitoneal injection of dexamethasone, cisplatin, or both, and in controls. Results: In patients, pCysC increases were greater than sCr 41% vs. 16%, mean paired difference 25% (95% CI: 16–34%)], relative increases were ≥ 50% in 9 patients (35%) for pCysC compared with 2 (8%) for sCr (p = 0.04) and increases in sCr were accompanied by increased KIM-1 and clusterin excretion, but increases in pCysC alone were not. In rats, dexamethasone administration produced dose-dependent increases in pCysC (and augmented cisplatin-induced increases in pCysC), but did not augment histological injury, increases in sCr, or KIM-1 and clusterin excretion. Conclusions: In the presence of dexamethasone, elevation of pCysC does not reliably diagnose AKI after cisplatin-based chemotherapy. |
topic |
Cystatin C Creatinine Acute kidney injury Biomarkers Dexamethasone |
url |
http://www.karger.com/Article/FullText/469715 |
work_keys_str_mv |
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