Measurement of serum cystatin C, creatinine clearance and urea micro-albumin as renal function evaluation indicators in cancer patients during chemotherapy with platinum
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- Cai, X., Xue, P., Gu, M. et al. Chin. -Ger. J. Clin. Oncol. (2011) 10: 235. doi:10.1007/s10330-011-0777-8
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Chemotherapy drugs such as platinum may cause damage to the renal function, creatinine clearance (Ccr), as a “golden standard” indicator in clinical evaluation of renal function, was limited in application due to complicated detection steps. By detecting the expression of serum Cystatin C (Cys C), Ccr and urinary micro-albumin (UMA), this study was designed to analyze and discuss their roles and status in renal function evaluation for cancer patients before and after chemotherapy with platinum.
We retrospectively reviewed 110 patients who receiving platinum-containing protocols or non-platinum-containing ones, and got the expression of Cys C, Ccr (was calculated by Cockcroft-Gault equation) and UMA, then analyzed whether there were differences for Cys C,Ccr and UMA in those patients; for patients with mildly impaired renal function (Ccr between 50–75 mL/min), whether there were differences for Cys C and UMA before and after chemotherapy with platinum.
There was statistical significance for Ccr, Cys C and UMA in patients who receiving platinum-containing protocols (85.01 ± 28.40) vs (76.79 ± 26.63) mL/min, (1.49 ± 0.50) vs (1.80 ± 0.84) mg/L and (14.30 ± 9.15) vs (16.90 ± 10.95) mg/L, P = 0.00, 0.00 and 0.01), and no statistical significance for those receiving non-platinum-containing ones (89.45 ± 29.69) vs (86.78 ± 27.96) mL/min, (1.51 ± 0.78) vs (1.63 ± 0.73)mg/L and (17.31 ± 10.46) vs (16.59 ± 8.33) mg/L, P = 0.45, 0.07 and 0.57); and there were also significant differences for Cys C for patients with mildly impaired renal function before and after chemotherapy (1.68 ± 0.55) vs (2.04 ± 0.68) mg/L, P = 0.03), while no statistical significance for UMA for the same ones (21.11 ± 10.06) vs (21.22 ± 8.81) mg/L, P = 0.93). There were statistical significance both for Cys C and UMA before and after chemotherapy in platinum-containing group, but the AUC for Ccr and Cys C is greater than that for UMA (P < 0.02).
Cys C and UMA can both access renal dysfunction early after chemotherapy, but Cys C is more sensitive than UMA in reflecting early renal dysfunction, so Cys C can replace Ccr and become a reliable indicator in the assessment of renal function for cancer patients before and after chemotherapy especially with platinum.