Urinary α- Glutathione-s-transferase variations in cisplatin treated cancer patients with and without kidney injury

Ummer, Saleena V and Athiyamaan, MS and Vadhiraja, BM and Prabhu, Raveendra and Nalini, K (2012) Urinary α- Glutathione-s-transferase variations in cisplatin treated cancer patients with and without kidney injury. IPCBEE, 31. pp. 27-31.

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Introduction: One of the most common causes of Acute Kidney Injury is nephrotoxin administration. Platinum compounds like cisplatin are very effective as chemotherapeutic agents but the risk of nephrotoxicity frequently hinders the use of its higher dose to maximise its antineoplastic effects. The lack of early biomarkers of AKI has impaired our ability to initiate the preventive interventions in the nephrotoxicity caused by these agents in a timely manner. This study was designed to evaluate the variation of urinary renal tubular cell specific enzyme α-Glutathione-s-transferase(α-GST) in cancer patients treated with cisplatin chemotherapy. The urinary levels of α-GST, studied in a timely manner may help in identifying patients who may benefit from early interventions. Methodology: This is a prospective observational cohort study in patients with head and neck malignancies qualified for three weekly chemosensitiser with cisplatin( dose 100mg/m2). Venous blood samples were collected from all the patients, (after obtaining Institutional ethical clearance) before the adminsitration of cisplatin (baseline), and at 12 hours, 24 hours, 48 hours and 20days after cisplatin infusion and a random urine sample was collected before and at 2 hrs , 6 hrs, 12 hrs, 24hrs and 48hrs after cisplatin administration. Serum creatinine was estimated by Jaffe‘s method using commercial reagent kit. and α –GST was estimated in all the urine samples by colorimetric kinetic assay using NBD-Cl. Results: There was a 20.5% incidence of acute kidney injury after cisplatin administration as suggested by a significant rise in the serum creatinine levels within the first 48 hours. The mean urinary α-Glutathione S Transferase levels at different time intervals show a clear temporal rise, especially after 2 hours after cisplatin administration, and at a slower rate thereafter. Discussion: We observed that, in AKI group, there was a substantial rise in the enzyme values following cisplatin administration. The peak rise was seen around 6 hrs after cisplatin infusion, which was followed by a steady fall. Whereas the significant increase in serum creatinine was observed only after 48hrs. Hence an earlier detection of rise in enzyme levels could help in prompt intervention and prevention of further renal damage.

Item Type: Article
Uncontrolled Keywords: Acute Kidney Injury, α-Glutathione-s-transferase, Nephrotoxicity, Acute Kidney Injury Network, Cisplatin Applications
Subjects: Allied Health > MCOAHS Manipal > Medical Laboratory Tech
Medicine > KMC Manipal > Biochemistry
Medicine > KMC Manipal > Nephrology
Medicine > KMC Manipal > Radiotherapy and Oncology
Depositing User: KMC Manipal
Date Deposited: 09 May 2012 04:18
Last Modified: 09 May 2012 04:18
URI: http://eprints.manipal.edu/id/eprint/76387

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