The Significance of Urinary RBP and KIM-1 Determination in Cisplatin – Induced Acute Kidney Injury

Yang Haoqiang,Meng Xiaoyan,Zhang Min,Shu Tingting,Huang Xiangyang,Tan Hechang

doi:10.11648/j.sjcm.20211002.16

Abstract

Objective: Cisplatin is one of the most commonly used and most effective chemotherapy drugs in clinical treatment of solid tumors, because of its strong anti-cancer effect, no cross resistance with other cancer drugs, but cisplatin is one of the significant renal toxicity drugs either, which greatly limits its clinical application. The traditional diagnostic methods for AKI are to measure Scr and changes in urine volume, but these indicators are affected by non-renal factors and cannot reflect renal function in an early and timely manner, which delays the optimal early treatment time for AKI. To discuss the clinical value of detecting urinary retinol binding protein (RBP) and kidney injury molecule 1 (KIM-1) in early diagonsis of cisplatin-induced acute kidney injury. Methods: 48 rats were randomly divided into the cisplatin group (CP group, 42 rats) and the control group (NS group, 6 rats). The urinary RBP and KIM-1, renal pathological changes were observed at each injection time points. Results: Urinary KIM-1 it significantly increased at 12h point (P<0.05), which was higher obviously than NS group. Urinary RBP it significantly elevated at 6h point (P<0.05). It has correlation with Scr. Conclusion: In cisplatin-induced acute kidney injury, urinary RBP and KIM-1 increased obviously earlier than serum creatinine, they were early sensitive markers.

Highlights

With the rapid development of the pharmaceutical industry in recent years, new drugs have been applied in clinical practice, and drug-induced AKI has been increasing year by year, which has become an unavoidable problem for clinical medicine workers
2) At each time point after drug injection, SD rats were subjected to ventral median incision after ether inhalation anesthesia, and 5ml of blood was collected by portal venipuncture and put into EP tube and sent to the laboratory of our hospital for Scr and BUN determination; 0.8-1ml of urine was taken by bladder puncture and sent to the laboratory of our hospital for urine retinol binding protein (RBP) and kidney injury molecule 1 (KIM-1) determination; bilateral kidneys were taken and sent to the pathology department of our hospital for HE pathological section
The difference was statistically significant, reaching a peak value within 24h to 72h and presenting a decreasing trend within 72h to 96h. These results indicated that in the AKI model of rats induced by cisplatin, the expression of KIM-1 was significantly up-regulated within 12h, indicating that the increase of KIM-1 was much earlier than that of SCR, that is, KIM-1 compared with SCR was an early sensitive marker of acute kidney injury induced by cisplatin

Summary

Introduction

With the rapid development of the pharmaceutical industry in recent years, new drugs have been applied in clinical practice, and drug-induced AKI has been increasing year by year, which has become an unavoidable problem for clinical medicine workers. The higher the dose of cisplatin, the better the anti-tumor effect, at the same time, the stronger the nephrotoxicity, the greater the probability of renal injury. How to effectively ensure the quality of chemotherapy for cancer patients, reduce kidney injury, and better play the anti-tumor effect of cisplatin has become an urgent problem to be solved. Studies have shown that SCR increases only when glomerular filtration rate drops by more than 50%, which cannot achieve the purpose of early diagnosis and delays the optimal treatment time for AKI. It is an urgent requirement for new drug development and clinical treatment to find early, sensitive and quantifiable AKI markers

Methods

Results

Discussion

Conclusion