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Disease Markers
Volume 35 (2013), Issue 6, Pages 811–818
http://dx.doi.org/10.1155/2013/369784
Clinical Study

Interleukin 18 as a Marker of Chronic Nephropathy in Children after Anticancer Treatment

Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, 91-738 Łódź, Poland

Received 13 August 2013; Revised 10 October 2013; Accepted 25 October 2013

Academic Editor: Natacha Turck

Copyright © 2013 Małgorzata Zubowska et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.