%0 Journal Article
%T Interleukin 18 as a Marker of Chronic Nephropathy in Children after Anticancer Treatment
%A Ma£¿gorzata Zubowska
%A Krystyna Wyka
%A Wojciech Fendler
%A Wojciech M£¿ynarski
%A Beata Zalewska-Szewczyk
%J Disease Markers
%D 2013
%R 10.1155/2013/369784
%X Novel markers of nephrotoxicity, including kidney injury molecule 1 (KIM-1), interleukin 18 (IL-18), and beta-2 microglobulin, were used in the detection of acute renal injury. The aim of the study was to establish the frequency of postchemotherapy chronic kidney dysfunction in children and to assess the efficacy of IL-18, KIM-1, and beta-2 microglobulin in the detection of chronic nephropathy. We examined eighty-five patients after chemotherapy (median age of twelve years). The median age at the point of diagnosis was 4.2 years, and the median follow-up time was 4.6 years. We performed classic laboratory tests assessing kidney function and compared the results with novel markers (KIM-1, beta-2 microglobulin, and IL-18). Features of subclinical renal injury were identified in forty-eight children (56.3% of the examined group). Nephropathy, especially tubulopathy, appeared more frequently in patients treated with ifosfamide, cisplatin, and/or carboplatin, following nephrectomy or abdominal radiotherapy ( , , and , resp.). Concentrations of IL-18 and beta-2 microglobulin were comparable with classic signs of tubulopathy ( and ). Concentrations of IL-18 were also significantly higher in children treated with highly nephrotoxic drugs ( ) following nephrectomy ( ) and abdominal radiotherapy ( ). Concentrations of beta-2 microglobulin were higher after highly toxic chemotherapy ( ) and after radiotherapy ( ). ROC curves created utilizing IL-18 data allowed us to distinguish between children with nephropathy (value 28.8£¿pg/mL) and tubulopathy (37.1£¿pg/mL). Beta-2 microglobulin and IL-18 seem to be promising markers of chronic renal injury in children after chemotherapy. 1. Introduction Significantly improved results of anticancer treatment in children have led to an increased number of survivors. However, available data show that up to 40% of these children suffer from serious late complications, including heart failure, neurotoxicity, nephrotoxicity, growth impairment, hormonal disorders, and secondary cancers [1]. Late complications not only seriously impair the patients¡¯ quality of life and cause higher rates of hospitalization, but in 15% of cases, they become the direct cause of the patient¡¯s death [2, 3]. Therefore current studies focus on the problems of early diagnosis in the asymptomatic period of the disease, which can result in an order of prophylactic or therapeutic procedures to prevent the progression of late complications. The impairment of renal function after chemotherapy is a field of interest to many international study groups. According to
%U http://www.hindawi.com/journals/dm/2013/369784/