title: Early measurement of urinary N-acetyl-β-glucosaminidase helps predict severe hyponatremia associated with cisplatin-containing chemotherapy.
abstract: BACKGROUND
  Although cisplatin is a widely used anticancer drug for treating various types of cancer, its clinical application is limited by severe systemic toxicities, such as nephropathy, hematologic toxicity, and gastrointestinal toxicity. There are no reliable and validated biomarkers to predict adverse events caused by cisplatin.
  
  
  METHODS
  Sixty-six patients who underwent cisplatin-containing first-line chemotherapy between June 2010 and November 2013 were retrospectively analyzed. Data on urinary N-acetyl-β-glucosaminidase activities measured 24-48 h after cisplatin infusion were retrieved, and adverse events during the first course of chemotherapy were recorded according to the Common Terminology Criteria for Adverse Events version 4.0.
  
  
  RESULTS
  Patient characteristics were: male/female 60/6, median age 65 (range 36-78) years, esophageal/gastric/other cancer 60/4/2, chemotherapy regimen docetaxel-cisplatin-fluorouracil/fluorouracil-cisplatin/S-1-cisplatin 54/8/4, cisplatin dose (mg/sm) 60/70/80 16/43/7. Grade 3/4 adverse events were leukopenia (40.9%), neutropenia (54.4%), febrile neutropenia (37.9%), hyponatremia (28.8%), and acute kidney injury (37.9%). Patients with 20 units/gram creatinine or higher urinary N-acetyl-β-glucosaminidase developed statistically lower minimum serum sodium concentration (median 126 vs. 134 mEq/L, p = 0.0053). There were no significant correlations between urinary N-acetyl-β-glucosaminidase and the development of other severe adverse events.
  
  
  CONCLUSIONS
  Early significant increase in urinary N-acetyl-β-glucosaminidase predicts subsequent development of severe hyponatremia after cisplatin-containing chemotherapy.
authors: Department of Oncology and Hematology, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-Ku 105-8471, Tokyo, Japan. Electronic address: arakawaz@gmail.com.
authors: Yasuhiro
authors: Y
authors: Arakawa
authors: Department of Oncology and Hematology, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-Ku 105-8471, Tokyo, Japan.
authors: Miho
authors: M
authors: Tamura
authors: Department of Oncology and Hematology, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-Ku 105-8471, Tokyo, Japan.
authors: Toshikazu
authors: T
authors: Sakuyama
authors: Department of Oncology and Hematology, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-Ku 105-8471, Tokyo, Japan.
authors: Keisuke
authors: K
authors: Aiba
authors: Department of Surgery, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan.
authors: Seiichiro
authors: S
authors: Eto
authors: Department of Surgery, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan.
authors: Masami
authors: M
authors: Yuda
authors: Department of Surgery, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan.
authors: Yujiro
authors: Y
authors: Tanaka
authors: Department of Surgery, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan.
authors: Akira
authors: A
authors: Matsumoto
authors: Department of Surgery, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan.
authors: Katsunori
authors: K
authors: Nishikawa
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine*; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D015415:Biomarkers / Q000652:urine*; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced* / Q000175:diagnosis* / Q000652:urine; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D000118:Acetylglucosaminidase; D002945:Cisplatin
keywords: Cisplatin-containing chemotherapy; Hyponatremia; Urinary N-Acetyl-β-glucosaminidase