Urinary Neutrophil Gelatinase-associated Lipocalin as a Biomarker of Kidney Injury in Hematologic-Oncologic Patients Receiving Amphotericin B

Authors

  • Iman Karimzadeh Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran Author
  • Marziyeh Heydari Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran Author
  • Mani Ramzi Hematology Research Center and Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Author
  • Mohammad Mahdi Sagheb Nephrology-Urology Research Center and Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Author
  • Kamiar Zomorodian Basic Sciences in Infectious Diseases Research Center and Department of Medical Mycology and Parasitology, Shiraz University of Medical Sciences, Shiraz, Iran Author

Abstract

Introduction. The aim of the present study was to compare the changing pattern of urine neutrophil gelatinase-associated lipocalin (NGAL) with serum as well as urine creatinine during amphotericin B treatment and determine its accuracy in the early detection of amphotericin B nephrotoxicity.

Materials and Methods. A cohort study was performed during 9 months at 3 hematology-oncology services. Patients aged 15 years and greater with no documented history of acute kidney injury or chronic kidney disease, planned to receive any formulation of amphotericin B for at least 1 week, were included. Serum as well as urine creatinine and urine NGAL were determined on days zero, 3, 5, 7, 10, and 14 of amphotericin B treatment.

Results. Forty patients with the mean age of 38.0 ± 14.1 years were recruited. Eleven of 40 patients (27.5%) developed amphotericin B nephrotoxicity. The overall changes in the mean values of urine NGAL were not significant during amphotericin B treatment, neither within nor between the two groups. The area under the curve of urine NGAL (0.765; 95% confidence interval, 0.588 to 0.962) on day zero was significantly higher than that of serum creatinine (0.464; 95% confidence interval, 0.268 to 0.660; P = .01) for predicting amphotericin nephrotoxicity.

Conclusions. The incremental pattern of urine NGAL during amphotericin B treatment was not significant compared to baseline values. The urine level of NGAL on the first day of amphotericin B administration was more accurate than serum creatinine in predicting acute kidney injury caused by this agent.

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Published

2017-05-31

Issue

Section

ORIGINAL | Kidney Diseases

How to Cite

Urinary Neutrophil Gelatinase-associated Lipocalin as a Biomarker of Kidney Injury in Hematologic-Oncologic Patients Receiving Amphotericin B. (2017). Iranian Journal of Kidney Diseases, 11(3), 201-208. https://www.ijkd.org/index.php/ijkd/article/view/2926

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