Natriuretic Peptides Role in Determining the Chemotherapy-Induced Nephrotoxicity and Their Value in Follow-Up

Abstract

Background: Chemotherapy-induced nephrotoxicity is an important handicap for optimal treatment. For this reason, we need useful markers for early detection of chemotherapy-induced renal disfunction. This study was performed to investigate the relationship between the plasma natriuretic peptides (ANP and BNP) levels and chemotherapy-induced nephrotoxicity.

Methods: Thirty patients treated with cisplatin, cyclophosphamide, doxorubicin and cytosine arabinoside which having known nephrotoxic side effects, were enrolled in this study. Seventeen of the patients were male and 13 were female with a median age of 44. Also 30 healthy person were included to this study. Four chemotherapy courses were administered to each patient. Renal function tests (BUN, creatinin, urine micrototal protein/creatinin [Pr/Cr], glomeruler filtration rate (GFR) and urine Na) and plasma levels of ANP and BNP were measured before and after the treatments in both the patient and the control group.

Results: Before the treatment, there was no significant difference between the patients and the control group in comparison of renal function tests and plasma ANP-BNP levels. However, a decline in GFR, increase in urine Pr/Cr and plasma ANP-BNP levels were observed with subsequent courses of chemotherapy protocol, which were considered statistically significant (P < 0.001). The plasma levels of ANP and BNP appeared to be higher in patients treated with nephrotoxic anticancer agents.

Conclusions: The elevated levels of natriuretic peptides may be useful in determining the chemotherapy-induced nephrotoxicity earlier, which highlights their importance and role in follow-up.




doi:10.4021/wjnu7e