Comparison of methods of evaluating nephrotoxicity of cis-platinum

Abstract

The urinary excretion of leucine aminopeptidase (LAP), N-acetyl-.beta.-glucosaminidase (NAG), and .beta.2-microglobulin [.beta.2-MG] was measured in 12 cancer patients receiving cis-platinum to evaluate the sensitivity of these indices for renal tubular damage. NAG and LAP excretion rose markedly in all patients, and .beta.2-MG rose in 11. Of the 9 patients, who received cis-platinum 6 wk before the study 7 had prestudy dose elevations of 1 or more of these indices. These urinary proteins are apparently sensitive indicators of proximal renal tubular injury and may provide greater sensitivity for comparison of the nephrotoxic potential of future platinum analogs or for assessing the efficacy of regimens designed to protect the kidney from platinum nephrotoxicity than other measurements. The persistence of high excretion values for these indices 6 wk after a dose demonstrates the persistent renal injury by cis-platinum.