Objective:Chemotherapy drugs such as platinum may cause damage to the renal function,creatinine clearance(Ccr),as a "golden standard" indicator in clinical evaluation of renal function,was limited in applica...Objective:Chemotherapy drugs such as platinum may cause damage to the renal function,creatinine clearance(Ccr),as a "golden standard" indicator in clinical evaluation of renal function,was limited in application due to complicated detection steps.By detecting the expression of serum Cystatin C(Cys C),Ccr and urinary micro-albumin(UMA),this study was designed to analyze and discuss their roles and status in renal function evaluation for cancer patients before and after chemotherapy with platinum.Methods:We retrospectively reviewed 110 patients who receiving platinum-containing protocols or non-platinum-containing ones,and got the expression of Cys C,Ccr(was calculated by Cockcroft-Gault equation) and UMA,then analyzed whether there were differences for Cys C,Ccr and UMA in those patients;for patients with mildly impaired renal function(Ccr between 50-75 mL/min),whether there were differences for Cys C and UMA before and after chemotherapy with platinum.Results:There was statistical significance for Ccr,Cys C and UMA in patients who receiving platinum-containing protocols(85.01 ± 28.40) vs(76.79 ± 26.63) mL/min,(1.49 ± 0.50) vs(1.80 ± 0.84) mg/L and(14.30 ± 9.15) vs(16.90 ± 10.95) mg/L,P = 0.00,0.00 and 0.01),and no statistical significance for those receiving non-platinum-containing ones(89.45 ± 29.69) vs(86.78 ± 27.96) mL/min,(1.51 ± 0.78) vs(1.63 ± 0.73)mg/L and(17.31 ± 10.46) vs(16.59 ± 8.33) mg/L,P = 0.45,0.07 and 0.57);and there were also significant differences for Cys C for patients with mildly impaired renal function before and after chemotherapy(1.68 ± 0.55) vs(2.04 ± 0.68) mg/L,P = 0.03),while no statistical significance for UMA for the same ones(21.11 ± 10.06) vs(21.22 ± 8.81) mg/L,P = 0.93).There were statistical significance both for Cys C and UMA before and after chemotherapy in platinum-containing group,but the AUC for Ccr and Cys C is greater than that for UMA(P < 0.02).Conclusion:Cys C and UMA can both access renal dysfunction early after chemotherapy,but Cys C is more sensitive than UMA in reflecting early renal dysfunction,so Cys C can replace Ccr and become a reliable indicator in the assessment of renal function for cancer patients before and after chemotherapy especially with platinum.展开更多
文摘Objective:Chemotherapy drugs such as platinum may cause damage to the renal function,creatinine clearance(Ccr),as a "golden standard" indicator in clinical evaluation of renal function,was limited in application due to complicated detection steps.By detecting the expression of serum Cystatin C(Cys C),Ccr and urinary micro-albumin(UMA),this study was designed to analyze and discuss their roles and status in renal function evaluation for cancer patients before and after chemotherapy with platinum.Methods:We retrospectively reviewed 110 patients who receiving platinum-containing protocols or non-platinum-containing ones,and got the expression of Cys C,Ccr(was calculated by Cockcroft-Gault equation) and UMA,then analyzed whether there were differences for Cys C,Ccr and UMA in those patients;for patients with mildly impaired renal function(Ccr between 50-75 mL/min),whether there were differences for Cys C and UMA before and after chemotherapy with platinum.Results:There was statistical significance for Ccr,Cys C and UMA in patients who receiving platinum-containing protocols(85.01 ± 28.40) vs(76.79 ± 26.63) mL/min,(1.49 ± 0.50) vs(1.80 ± 0.84) mg/L and(14.30 ± 9.15) vs(16.90 ± 10.95) mg/L,P = 0.00,0.00 and 0.01),and no statistical significance for those receiving non-platinum-containing ones(89.45 ± 29.69) vs(86.78 ± 27.96) mL/min,(1.51 ± 0.78) vs(1.63 ± 0.73)mg/L and(17.31 ± 10.46) vs(16.59 ± 8.33) mg/L,P = 0.45,0.07 and 0.57);and there were also significant differences for Cys C for patients with mildly impaired renal function before and after chemotherapy(1.68 ± 0.55) vs(2.04 ± 0.68) mg/L,P = 0.03),while no statistical significance for UMA for the same ones(21.11 ± 10.06) vs(21.22 ± 8.81) mg/L,P = 0.93).There were statistical significance both for Cys C and UMA before and after chemotherapy in platinum-containing group,but the AUC for Ccr and Cys C is greater than that for UMA(P < 0.02).Conclusion:Cys C and UMA can both access renal dysfunction early after chemotherapy,but Cys C is more sensitive than UMA in reflecting early renal dysfunction,so Cys C can replace Ccr and become a reliable indicator in the assessment of renal function for cancer patients before and after chemotherapy especially with platinum.
