Glomerular dysfunction, independent of tubular dysfunction, induced by antineoplastic chemotherapy in children

Pediatr Int. 2004 Oct;46(5):570-5. doi: 10.1111/j.1442-200x.2004.01958.x.

Abstract

Background: For the purpose of studying renal side-effects induced by antineoplastic agents, the authors examined glomerular injury as well as tubular injury of patients with chemotherapy.

Methods: Thirteen patients underwent a combined total of 64 courses of chemotherapy. Urinary albumin, beta2-microglobulin (beta2-MG), N-acetyl-beta-glucosaminidase (NAG) and urinary protein were measured before and serially after chemotherapy.

Results: The values of albumin/creatinine (albumin/cre) ratio and beta2-MG/creatinine (beta2-MG/cre) ratio after chemotherapy were higher than those before chemotherapy (P <0.01). NAG/creatinine (NAG/cre) ratio and creatinine clearance (Ccr) were not different. These were also examined before the next course of chemotherapy and were compared with those of control children. Albumin/cre ratio was significantly different (P <0.01). beta2-MG/cre ratio and NAG/cre were not different. Furthermore, in patients with normal beta2-MG/cre, the albumin/cre ratio was significantly higher than in control children.

Conclusions: These results indicate that antineoplastic agents can not only induce tubular dysfunction but also glomerular dysfunction, which is persistent and independent of tubular dysfunction.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Acute Disease
  • Adolescent
  • Albuminuria / etiology
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Asparaginase / administration & dosage
  • Asparaginase / adverse effects
  • Child
  • Child, Preschool
  • Creatinine / urine*
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / adverse effects
  • Cytarabine / administration & dosage
  • Cytarabine / adverse effects
  • Doxorubicin / administration & dosage
  • Doxorubicin / adverse effects
  • Etoposide / administration & dosage
  • Etoposide / adverse effects
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Kidney Tubules / drug effects*
  • Kidney Tubules / physiopathology
  • Leukemia / drug therapy
  • Lymphoma / drug therapy
  • Methotrexate / administration & dosage
  • Methotrexate / adverse effects
  • Neoplasms / drug therapy*
  • Neuroblastoma / drug therapy
  • Osteosarcoma / drug therapy
  • Proteinuria / etiology
  • Rhabdomyosarcoma / drug therapy
  • Vincristine / administration & dosage
  • Vincristine / adverse effects

Substances

  • Cytarabine
  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Creatinine
  • Asparaginase
  • Methotrexate