title: Evaluation of the cisplatin nephrotoxicity using the urinary neutrophil gelatinase-associated lipocalin (NGAL) in patients with head and neck cancer.
abstract: BACKGROUND
  Acute kidney injury (AKI) in patients receiving cisplatin is common, therefore the evaluation of renal function in patients on use of nephrotoxic drugs is fundamental.
  
  
  OBJECTIVE
  To evaluate the incidence of AKI and the role of lipocalin associated to neutrophil gelatinase (NGAL) in the monitoring of renal function in patients with head and neck cancer (HNC) who received cisplatin.
  
  
  METHODS
  We prospectively studied 50 patients with HNC treated with three sessions of cisplatin. Blood and urine were collected 24 hours before cisplatin, 24 hours after infusion, 48 hours after each application and 35 days after the end of treatment (urine NGAL, C-reactive protein, creatinine, glomerular filtration rate, plasma lactate dehydrogenase and magnesium).
  
  
  RESULTS
  AKI was observed in 78% of patients. There was increase in creatinine, and decrease in GFR after each cycle of cisplatin, and increased urine NGAL. Positive association was observed between the levels of NGAL, creatinine and C-reactive protein. It was observed an increase in creatinine, NGAL, C-reactive protein and decreased GFR in AKI patients compared to patients without AKI.
  
  
  CONCLUSIONS
  AKI was noted in 78% of patients with HNC treated with cisplatin and showed the correlation of NGAL with creatinine and GFR in demonstrating renal injury. NGAL levels may be elevated compared to baseline levels, even before the use of cisplatin.
authors.affiliation: Universidade Estadual do Oeste do Paraná.
authors.forename: Luis Alberto Batista
authors.initials: LA
authors.lastname: Peres
authors.affiliation: Universidade Estadual do Oeste do Paraná.
authors.forename: Ademar Dantas
authors.initials: AD
authors.lastname: da Cunha
authors.affiliation: Universidade Federal do Paraná.
authors.forename: Rosangela Aparecida Botinha
authors.initials: RA
authors.lastname: Assumpção
authors.affiliation: Faculdade Assis Gurgacz.
authors.forename: Alex
authors.initials: A
authors.lastname: Schäfer
authors.affiliation: Faculdade Assis Gurgacz.
authors.forename: Aline Liene
authors.initials: AL
authors.lastname: da Silva
authors.affiliation: Faculdade Assis Gurgacz.
authors.forename: Arianne Ditzel
authors.initials: AD
authors.lastname: Gaspar
authors.affiliation: Faculdade Assis Gurgacz.
authors.forename: Deborah Francisca
authors.initials: DF
authors.lastname: Scarpari
authors.affiliation: Faculdade Assis Gurgacz.
authors.forename: Julia Barazetti Ferrari
authors.initials: JB
authors.lastname: Alves
authors.affiliation: Faculdade Assis Gurgacz.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Girelli Neto
authors.affiliation: Faculdade Assis Gurgacz.
authors.forename: Thaís Figueiredo Teodoro
authors.initials: TF
authors.lastname: de Oliveira
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D000970:Antineoplastic Agents / Q000633:toxicity*; D002945:Cisplatin / Q000633:toxicity*; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000652:urine*; D006801:Humans; D015994:Incidence; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine*
chemical_list: D000209:Acute-Phase Proteins; D000970:Antineoplastic Agents; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D002945:Cisplatin