Alaa Sabry
Mansoura University, Egypt.
Title: KIDNEY INJURY MOLECULE 1 (KIM-1) AS AN EARLY PREDICTOR FOR AKI INDUCED BY PLATINUM BASED CHEMOTHERAPY
Biography
Biography: Alaa Sabry
Abstract
Background AKI is a disease associated with high morbidity and mortality. Drug induced AKI is a common cause of AKI. Traditional biomarkers (i.e. creatinine, UOP) can’t provide early diagnosis for AKI, so there is increasing need for novel biomarker. Many novel biomarkers emerged to solve this problem. One of them is KIM-1. We studied its’ ability for early diagnosis of AKI in patient taking therapeutic platinum based chemotherapy.
Methods We prospectively analyzed 132 patients taking platinum based chemotherapy treatment. AKI patients was diagnosed according to KDIGO 2012. Serum creatinine were done for all patients prior to and at 2nd and 5th days of each cycle. Serum calcium and magnesium were done for all patients basal (before 1st day of 1st cycle) and at end point. Urinary KIM-1 concentrations were assessed prior to and at 2nd and 5th days of chemotherapy cycle.
*End point for each patient was one of the following:-
1. In non AKI patients was the completion of platinum based chemotherapy plane.
2. In AKI patients was the day which AKI was occurred.
Results AKI occurred in 35 patients (26.52% of patients). Serum calcium and magnesium significantly decreased between basal and at end point (P= 0.000).KIM 1 showed significant increase in sample(b) in comparison to sample(c) (P= 0.004)and significant increase in sample(a) in comparison to sample(c)(P= 0.001), but insignificant increase in sample(a) in comparison to sample(b) (P=0.117)(table-1).
*Sample a (Urine sample of AKI day), Sample b (Urine sample collected day before Sample a) and Sample c (Collected day before Sample b).
Table (1): Mean values of KIM 1 in AKI group (comparing mutable values of patients):
|
AKI Patients (n=35) |
ng/ml |
P* |
|
|
KIM 1 |
Sample a(mean±SD) |
2.25 ± 0.87 |
0.117 |
|
Sample b(mean±SD) |
2.10 ± 0.78 |
||
|
KIM 1 |
Sample b(mean±SD) |
2.10 ± 0.78 |
0.004 |
|
Sample c(mean±SD) |
1.5 ± 0.34 |
||
|
KIM 1 |
Sample a(mean±SD) |
2.25 ± 0.87 |
0.001 |
|
Sample c(mean±SD) |
1.5 ± 0.34 |
||
There was significant between marker value in comparison to comparative group (p= 0.000)(chart 1).
The best capacity for urinary KIM-1 to discriminate between AKI group and comparative group was found at sample b (Chart 1)
*Comparative group, ware 35 patient from non AKI group, KIM1 was analyzed in similar day and cycle to AKI occurrence in AKI group. Patients are selected to be well matched to AKI group as regard to age, gender, malignant disease and type and dose of chemotherapy.
Chart (1): Comparing sample a & b versus comparative group.
|
|
Area under curve |
P* |
95 % Confidence Interval |
|
Sample a |
0.911 |
0.000 |
0.822 - 0.999 |
|
Sample b |
0.954 |
0.000 |
0.895 - 1.013 |
Conclusions AKI is a common complication in patients receiving platinum based chemotherapy. Urinary KIM-1concentrations may predict platinum based chemotherapy induced AKI in early stages with high sensitivity and specificity.