Urinary Neutrophil Gelatinase Associated Lipocalin (NGAL) in Predicting Cisplatin-Induced Acute Kidney Injury

Background: Acute kidney injury (AKI) is a serious complication of treatment in patients receiving Cisplatin. It is not completely inevitable despite all preventive and supportive measures. Objectives: This study aimed at comparing urine NGAL with other conventional biomarkers (serum Cr, BUN) and GFR in predicting Cisplatin-induced AKI. Methods: Overall, 35 eligible patients, who received Cisplatin containing chemotherapy were recruited from a referral center of Tehran, Iran. Baseline and subsequent post Cisplatin treatment levels of BUN, Cr, and Urinary NGAL were measured. Changes in biomarkers versus baseline over time were studied. The ROC curves were constructed to test their ability to predict AKI at different points of time. Results: Of the 35 patients in the study, six (17%) experienced AKI, exclusively limited to stage 1. There were no significant differences between AKI and non-AKI patients regarding age, gender, and type of malignancy (P > 0.05). There were significant differences in day three Cr (P = 0.01), day six Cr (P = 0.03), and day three BUN (P = 0.01) between the two groups. Unadjusted marginal linear regression model suggested a significant difference between two groups, regarding NGAL (P = 0.04) and BUN (P = 0.01) levels over time. The adjusted model only validated BUN (P = 0.04). The area under curve (SD) for urine NGAL measured six hours after Cisplatin treatment was 0.94 (0.04) (P = 0.06). Conclusions: The findings suggest that urine NGAL measured 24 hours after Cisplatin treatment could be a promising candidate biomarker to predict AKI in patients receiving Cisplatin containing chemotherapy.