A prospective pilot study of kidney-specific biomarkers to detect acute kidney injury after cytoreduction and hyperthermic intraperitoneal chemotherapy.
Chao-Yu Chen, Ting-Yao Wang, Hung-Yu Chang, Min-Chi Chen, Lan-Yan Yang
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Abstract
Background: Acute kidney injury (AKI) is a critical morbidity after cytoreduction and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC).
Objective: This study was conducted to investigate the use of kidney-specific biomarkers to evaluate the diagnostic accuracy of post-HIPEC AKI.
Methods: Patients who received CRS/HIPEC were prospectively enrolled in this study. We serially sampled urine neutrophil gelatinase-associated lipocalin (NGAL), serum cystatin C (sCyC), and β2 microglobulin (sβ2-MG) on the day before CRS/HIPEC and then 2 h, 1 d, 2 d, 3 d, and 7 d after CRS/HIPEC. The primary outcome was the occurrence of AKI during the first 7 d. The areas under the receiver operating characteristic curve (AUCs) were calculated to evaluate the detection performance.
Results: A total of 75 patients were eligible, of whom 5 (6.7%) fulfilled the criteria of AKI during the study period (AKI group) and 70 did not (non-AKI group). No significant differences were observed in these biomarkers between the two groups, except for sβ2-MG on day 3 (P = 0.025). Regarding changes in biomarker concentrations, the AKI group had a significantly higher concentration range of sCyC on day 3 (P = 0.009) and sβ2-MG on day 1 and day 3 (P = 0.013 and 0.019).
Conclusions: This is the first prospective study to evaluate the value of kidney-specific biomarkers in patients after CRS/HIPEC. We found that AKI cannot be predicted by simply using the absolute measurements of these biomarkers because of the heterogeneous characteristics of the patients.
期刊介绍：
Asian Biomedicine: Research, Reviews and News (ISSN 1905-7415 print; 1875-855X online) is published in one volume (of 6 bimonthly issues) a year since 2007. [...]Asian Biomedicine is an international, general medical and biomedical journal that aims to publish original peer-reviewed contributions dealing with various topics in the biomedical and health sciences from basic experimental to clinical aspects. The work and authorship must be strongly affiliated with a country in Asia, or with specific importance and relevance to the Asian region. The Journal will publish reviews, original experimental studies, observational studies, technical and clinical (case) reports, practice guidelines, historical perspectives of Asian biomedicine, clinicopathological conferences, and commentaries
Asian biomedicine is intended for a broad and international audience, primarily those in the health professions including researchers, physician practitioners, basic medical scientists, dentists, educators, administrators, those in the assistive professions, such as nurses, and the many types of allied health professionals in research and health care delivery systems including those in training.
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