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, β2microglobulin (β2-MG), N-acetyl-β-glucosaminidase (NAG) and urinary protein were measured before and serially after chemotherapy. Results: The values of albumin/creatinine (albumin/cre) ratio and β2-MG/creatinine (β2-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). β2-MG/cre ratio and NAG/cre were not different. Furthermore, in patients with normal β2-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.