Cisplatin treatment in cancer patients before and after ichemia modified albumin and paraoxonase-1 levels evaluation

Introduction: Cisplatin is a potent chemotherapeutic agent used in cancer treatment but has dose-limiting side effects such as nephrotoxicity, ototoxicity, and myelosuppression. Cisplatin nephrotoxicity is clinically reflected in various ways. The most common of these is acute kidney injury (AKI). In this study, it was aimed to evaluate whether ischemia modified albumin (IMA) and paraoxonase-1 (PON 1) molecules can be an early and accurate indicator of acute kidney injury due to cisplatin-related nephrotoxicity in cancer patients receiving cisplatin chemotherapy. Materials and methods: The study was conducted with 40 patients who started cisplatin chemotherapy in Düzce University Training and Research Hospital Oncology Clinic. Patients with previous chemotherapy, any nephrotoxic drug use, diabetes, hypertension, and chronic kidney disease (CKD) were excluded from the study. IMA and PON-1 levels were evaluated before cisplatin treatment and after the third cure treatment. Results: After the treatment, statistically significant decreases were observed in the numbers of IMA, PON-1, IMA/Albumin ratio, creatinine clearance, albumin, hemoglobin, venous blood gas pH, leukocytes, neutrophils, lymphocytes, eosinophils and basophils; A significant increase was found in venous blood gas lactate levels (p<0.05). A statistically significant decrease (p=0.007) was observed in the body mass index (BMI) of the patients after the third cycle of treatment. When the correlations between the changes in IMA, PON-1, IMA/Albumin values before and after the treatment and the changes in other biochemistry parameters were compared; While there was a weak positive correlation between PON-1 and creatinine clearance and serum albumin levels, a weak but negative correlation was found between PON-1 and CRP. No statistically significant correlation was found between IMA IMA/Albumin and other biochemistry parameters. Conclusion: In this study, IMA, PON-1, IMA/Albumin ratio and creatinine clearance were significantly decreased in patients after cisplatin treatment. Although PON-1 level is thought to be an important follow-up parameter in the iv early diagnosis and course of the disease in acute kidney injury; The decrease in the IMA level, which we think is related to the increase in lactate levels, was not considered to be an indicator of acute kidney injury, since it reduces the diagnostic sensitivity of IMA. Keywords: cisplatin, acute kidney injury, IMA, PON-1