Morphological differences between glomerular epithelial cells (GEC) excreted during chemotherapy with antineoplastic drugs and GEC excreted in renal diseases

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

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.