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Anthracycline antibiotics induce acute renal tubular toxicity in children with cancer

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Pathology & Oncology Research

Abstract

Experimental evidence suggests that anthracyclines, widely used in cancer chemotherapy, may impair kidney function. We assessed kidney function by serum creatinine, urinary N-acetyl-β-D-glucosaminidase activity indices (NAGi) and microalbuminuria (MA) in 160 serum and urine samples obtained from 66 children with cancer. The effect of dexrazoxane was analyzed in 6 children on dexrazoxane supportive therapy in conjunction with daunorubicin (DNR) treatment, as compared with 6 children not receiving this agent. NAG; was significantly (p<0.05) elevated after treatment by DNR, doxorubicin, epirubicin (EPI) and idarubicin (IDA). MA proved to be a less sensitive indicator of kidney damage than NAGL DNR resulted in a progressive deterioration of proximal tubular function as determined by linear regression analysis. The mean NAG1 in the dexrazoxanetreated group was significantly (p<0.005) lower than in children not receiving dexrazoxane prior to DNR treatment. In conclusion, our study demonstrated that DNR, EPI and IDA induced an acute renal tubular damage similar to known tubulotoxic agents as cisplatin, carboplatin, cyclophosphamide and ifosfamide. The damage was clinically mild and only a minor proportion of patients can be expected to develop long-lasting tubulopathy with negative impact on the quality of life.

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Abbreviations

NAGi:

N-acetyl-β-D-glucosaminidase activity normalized for urinary creatinine concentration

MA:

microalbuminuria

DNR:

daunorubicin

DXR:

doxorubicin

CDDP:

cisplatin

CARBO:

carboplatin

CYC:

cyclophosphamide

VCR:

vincristine

EPI:

epirubicin

IDA:

idarubicin

IFO:

ifosfamide

MHSCUD:

Medical and Health Science Center of the University of Debrecen

HPOG:

Hungarian Pediatric Oncology Group

ALL:

acute lymphoblastic leukemia

NHL:

non-Hodgkin lymphoma

SR:

standard risk

IR:

intermediate

HR:

high risk

ECG:

electrocardiography

SD:

standard deviation

CARBO:

carboplatin

IFO:

ifosfamide

ASCO:

American Society of Clinical Oncology

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Authors and Affiliations

  1. Department of Pediatrics, Medical and Health Science Center, University of Debrecen, 98. Nagyerdei körút, P.O.Box 32, H-4012, Debrecen, Hungary

    Edit Bárdi, Ildikó Bobok & Csongor Kiss

  2. Department of Clinical Biochemistry and Molecular Pathology, Medical and Health Science Center, University of Debrecen, Hungary

    Anna V. Oláh & János Kappelmayer

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  1. Edit Bárdi
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  2. Ildikó Bobok
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  3. Anna V. Oláh
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  4. János Kappelmayer
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  5. Csongor Kiss
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Correspondence to Edit Bárdi.

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Bárdi, E., Bobok, I., Oláh, A.V. et al. Anthracycline antibiotics induce acute renal tubular toxicity in children with cancer. Pathol. Oncol. Res. 13, 249–253 (2007). https://doi.org/10.1007/BF02893506

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  • DOI: https://doi.org/10.1007/BF02893506

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