Urinary biomarkers of kidney injury in patients treated with anti-VEGF drugs
Background. Antiangiogenic drugs are widely used in oncological practice and are aimed at inhibiting angiogenesis. Despite the high antitumor efficacy, their use may be limited by nephrotoxicity, and therefore the search for early biomarkers of kidney damage remains relevant, which will preserve a f...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | Russian |
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"Consilium Medicum" Publishing house
2022-08-01
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| Series: | Терапевтический архив |
| Subjects: | |
| Online Access: | https://ter-arkhiv.ru/0040-3660/article/viewFile/109608/83862 |
| _version_ | 1811315598829813760 |
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| author | Katerina S. Grechukhina Natalia V. Chebotareva Liudmila G. Zhukova Tatiana V. Androsova Vladimir V. Karpov Tatiana N. Krasnova |
| author_facet | Katerina S. Grechukhina Natalia V. Chebotareva Liudmila G. Zhukova Tatiana V. Androsova Vladimir V. Karpov Tatiana N. Krasnova |
| author_sort | Katerina S. Grechukhina |
| collection | DOAJ |
| description | Background. Antiangiogenic drugs are widely used in oncological practice and are aimed at inhibiting angiogenesis. Despite the high antitumor efficacy, their use may be limited by nephrotoxicity, and therefore the search for early biomarkers of kidney damage remains relevant, which will preserve a favorable safety profile of therapy.
Aim. To determine urinary biomarkers of tubular and podocyte damage in patients receiving treatment with antiangiogenic drugs.
Materials and methods. The study included patients (n=50) who received intravenous anti-VEGF drugs (aflibercept, bevacizumab, ramucirumab) in various chemotherapy regimens. Concentrations of tubular damage markers KIM-1 (Kidney Injury Molecule-1) and NGAL (Neutrophil Gelatinase-Associated Lipocalin), hypoxia marker HIF-1 (Hypoxia-Inducible Factor 1-alpha) in urine samples were determined by enzyme-linked immunosorbent assay (ELISA) before treatment, and during 8 weeks of treatment. To assess the risk factors for kidney damage, a logistic regression analysis was performed with the inclusion of the main clinical and laboratory parameters.
Results. A decrease in the calculated GFR of CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration Formula) of less than 60 ml/min per 1.73 m2 at week 8 of treatment was noted in 42% of patients. An increase in NGAL, KIM-1, HIF-1 and nephrin in urine during the first two weeks of therapy predicted the development of renal damage by the 8th week of follow-up. When constructing ROC-curves, the high sensitivity and specificity of these urinary indicators as prognostic markers were established. Among the clinical and laboratory indicators, independent unfavorable prognostic factors of nephrotoxicity were an initial decrease in eGFR, a history of hypertension, an increase in the concentration of KIM-1 and HIF-1 in urine during the first two weeks of therapy.
Conclusion. The predictors of renal damage in the treatment with antiangiogenic drugs were previously an increase in NGAL, KIM-1 and HIF-1 in urine during the first two weeks after the start of therapy. |
| first_indexed | 2024-04-13T11:33:14Z |
| format | Article |
| id | doaj.art-9762bac841cd4ef18e1882e292ab16b7 |
| institution | Directory Open Access Journal |
| issn | 0040-3660 2309-5342 |
| language | Russian |
| last_indexed | 2024-04-13T11:33:14Z |
| publishDate | 2022-08-01 |
| publisher | "Consilium Medicum" Publishing house |
| record_format | Article |
| series | Терапевтический архив |
| spelling | doaj.art-9762bac841cd4ef18e1882e292ab16b72022-12-22T02:48:31Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422022-08-0194672573010.26442/00403660.2022.06.20156178127Urinary biomarkers of kidney injury in patients treated with anti-VEGF drugsKaterina S. Grechukhina0https://orcid.org/0000-0002-0616-5477Natalia V. Chebotareva1https://orcid.org/0000-0003-2128-8560Liudmila G. Zhukova2https://orcid.org/0000-0003-4848-6938Tatiana V. Androsova3https://orcid.org/0000-0002-9951-126XVladimir V. Karpov4https://orcid.org/0000-0003-2048-3401Tatiana N. Krasnova5https://orcid.org/0000-0002-7647-3942Lomonosov Moscow State UniversityLomonosov Moscow State UniversityLoginov Moscow Clinical Scientific CenterSechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Lomonosov Moscow State UniversityBackground. Antiangiogenic drugs are widely used in oncological practice and are aimed at inhibiting angiogenesis. Despite the high antitumor efficacy, their use may be limited by nephrotoxicity, and therefore the search for early biomarkers of kidney damage remains relevant, which will preserve a favorable safety profile of therapy. Aim. To determine urinary biomarkers of tubular and podocyte damage in patients receiving treatment with antiangiogenic drugs. Materials and methods. The study included patients (n=50) who received intravenous anti-VEGF drugs (aflibercept, bevacizumab, ramucirumab) in various chemotherapy regimens. Concentrations of tubular damage markers KIM-1 (Kidney Injury Molecule-1) and NGAL (Neutrophil Gelatinase-Associated Lipocalin), hypoxia marker HIF-1 (Hypoxia-Inducible Factor 1-alpha) in urine samples were determined by enzyme-linked immunosorbent assay (ELISA) before treatment, and during 8 weeks of treatment. To assess the risk factors for kidney damage, a logistic regression analysis was performed with the inclusion of the main clinical and laboratory parameters. Results. A decrease in the calculated GFR of CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration Formula) of less than 60 ml/min per 1.73 m2 at week 8 of treatment was noted in 42% of patients. An increase in NGAL, KIM-1, HIF-1 and nephrin in urine during the first two weeks of therapy predicted the development of renal damage by the 8th week of follow-up. When constructing ROC-curves, the high sensitivity and specificity of these urinary indicators as prognostic markers were established. Among the clinical and laboratory indicators, independent unfavorable prognostic factors of nephrotoxicity were an initial decrease in eGFR, a history of hypertension, an increase in the concentration of KIM-1 and HIF-1 in urine during the first two weeks of therapy. Conclusion. The predictors of renal damage in the treatment with antiangiogenic drugs were previously an increase in NGAL, KIM-1 and HIF-1 in urine during the first two weeks after the start of therapy.https://ter-arkhiv.ru/0040-3660/article/viewFile/109608/83862kidney injuryantiangiogenic therapythrombotic microangiopathyearly biomarkerskim-1ngalhif-1α |
| spellingShingle | Katerina S. Grechukhina Natalia V. Chebotareva Liudmila G. Zhukova Tatiana V. Androsova Vladimir V. Karpov Tatiana N. Krasnova Urinary biomarkers of kidney injury in patients treated with anti-VEGF drugs Терапевтический архив kidney injury antiangiogenic therapy thrombotic microangiopathy early biomarkers kim-1 ngal hif-1α |
| title | Urinary biomarkers of kidney injury in patients treated with anti-VEGF drugs |
| title_full | Urinary biomarkers of kidney injury in patients treated with anti-VEGF drugs |
| title_fullStr | Urinary biomarkers of kidney injury in patients treated with anti-VEGF drugs |
| title_full_unstemmed | Urinary biomarkers of kidney injury in patients treated with anti-VEGF drugs |
| title_short | Urinary biomarkers of kidney injury in patients treated with anti-VEGF drugs |
| title_sort | urinary biomarkers of kidney injury in patients treated with anti vegf drugs |
| topic | kidney injury antiangiogenic therapy thrombotic microangiopathy early biomarkers kim-1 ngal hif-1α |
| url | https://ter-arkhiv.ru/0040-3660/article/viewFile/109608/83862 |
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