BIOMARKERS OF DRUG NEPHROTOXICITY

Abstract

Antineoplastic drugs, especially those on the basis of platinum, used for chemotherapy of cancer can also affect various normal tissues and organs including kidneys. Cisplatin occupies one of the leading places and possesses the greatest nephrotoxisity. For many years nephrotoxicity has been evaluated at the level of serum creatinine and of blood urea nitrogen. However these markers have a number of essential shortcomings and do not provide early detection of AKI. To identify early AKI stages new more informative markers are needed, which could make evidence of emerging initial signs of disorders at the earliest and irrespective of filtrational function of kidneys. Characteristics of modern perspective markers of early disoeders of kidneys are presented in the review. Special attention is paid to the panel of markers of potential nephrotoxicity of drugs - candidates for clinical trials, which are recommended for preclinical study. The review presents data of investigations of the role of biomarkers in early diagnostics of AKI caused by cisplatin and its analogues. Use of the ROC analysis in these studies showed that new markers are more sensitive and specific than serum creatinine and blood urea nitrogen and can be used for diagnostics and monitoring of kidney disorders caused by chemotherapeutic drugs.