Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based Chemotherapy
Field | Value | Language |
dc.contributor.author | Pianta, Timothy J. | |
dc.contributor.author | Pickering, John W. | |
dc.contributor.author | Succar, Lena | |
dc.contributor.author | Chin, Melvin | |
dc.contributor.author | Davidson, Trent | |
dc.contributor.author | Buckley, Nicholas A. | |
dc.contributor.author | Mohamed, Fahim | |
dc.contributor.author | Endre, Zoltan H. | |
dc.date.accessioned | 2017-03-24 | |
dc.date.available | 2017-03-24 | |
dc.date.issued | 2017-03-17 | |
dc.identifier.citation | Pianta TJ, Pickering JW, Succar L, Chin M, Davidson T, Buckley NA, Mohamed F, Endre ZH. Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based Chemotherapy. Kidney Blood Press Res (2017). 42(1):62-75. | en_AU |
dc.identifier.uri | http://hdl.handle.net/2123/16558 | |
dc.description.abstract | BACKGROUND/AIMS: Plasma cystatin C (pCysC) may be superior to serum creatinine (sCr) as a surrogate of GFR. However, the performance of pCysC for diagnosing acute kidney injury (AKI) after cisplatin-based chemotherapy is potentially affected by accompanying corticosteroid anti-emetic therapy and hydration. METHODS: In a prospective observational study pCysC, sCr, urinary kidney injury molecule-1 (KIM-1), and urinary clusterin were measured over 2 weeks in 27 patients given first-cycle chemotherapy. The same variables were measured over 2 weeks in Sprague-Dawley rats given a single intraperitoneal injection of dexamethasone, cisplatin, or both, and in controls. RESULTS: In patients, pCysC increases were greater than sCr 41% vs. 16%, mean paired difference 25% (95% CI: 16-34%)], relative increases were ≥ 50% in 9 patients (35%) for pCysC compared with 2 (8%) for sCr (p = 0.04) and increases in sCr were accompanied by increased KIM-1 and clusterin excretion, but increases in pCysC alone were not. In rats, dexamethasone administration produced dose-dependent increases in pCysC (and augmented cisplatin-induced increases in pCysC), but did not augment histological injury, increases in sCr, or KIM-1 and clusterin excretion. CONCLUSIONS: In the presence of dexamethasone, elevation of pCysC does not reliably diagnose AKI after cisplatin-based chemotherapy. | en_AU |
dc.description.sponsorship | NHMRC Project Grant: 1011772. | en_AU |
dc.language.iso | en_AU | en_AU |
dc.publisher | Karger Publishers Open Access | en_AU |
dc.title | Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based Chemotherapy | en_AU |
dc.type | Article | en_AU |
dc.identifier.doi | 10.1159/000469715. | |
dc.type.pubtype | Publisher's version | en_AU |
usyd.department | Discipline of Pharmacology | en_AU |
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