The Significance Of Urinary Rbp And Ngal Determination In Cisplatin-induced Acute Kidney Injury

Objective:To discuss the clinical value of detecting urinary retinol binding protein (RBP) and neutrophil gelatinase-associated lipocalin (NGAL) in early diagonsis of cisplatin-induced acute kidney injury.Methods:48healthy male Sprague-Dawly (SD)rats were randomly divided into the cisplatin group (CP group,42rats) and the control group (NS group,6rats).CP group was subsequently divided into other seven groups according to the different intraperitoneal injection time of cisplatin:CP3h, CP6h, CP12h, CP24h, CP48h, CP72h, CP96h groups(6rats in each group). The serum creatinine (Scr), urea nitrogen (BUN), urinary RBP and NGAL, renal pathological changes were observed at each injection time points.Results:In the CP group,serum creatinine had no obvious change in24h, and began to increase during24h-48h,and significantly increased at48h point,which was higher obviously than NS group(P<0.05), Scr significantly increased>50%baseline at72h point. In CP group, BUN had the similar change at each time points.Urinary NGAL had no obvious change in6h in CP group,it began to increase during6h-12h, significantly increased at12h point(P<0.05), which was higher obviously than NS group,and it reached peak value within24h-72h; there was no correlation between Scr and urinary NGAL (P>0.05). Urinary RBP had no obvious change in3h in CP group, began to increase within3h-6h,significantly elevated at6h point (P<0.05),and it was upward trend within6h-96h;It has correlation with Scr.Pathological results:The NS group rat renal tissue HE staining:Renal organizational structure was clear and normal,and the structure of glomeruli and tubular were also normal, with less interstitial; The CP group rat renal tissue HE staining:the glomerulus was almost normal except sedimentation erythrocyte,but renal tubule degeneration was obvious, detached tubular epithelial cells,cytoplasmic vacuoles, lumen expansion, tubular congestion,interstitial inflammatory cell infiltration and even the accumulation of apoptotic were visible;And tubular lesions gradually aggravated following time.Conclusion:1. In cisplatin-induced acute kidney injury,urinary RBP and NGAL increased obviously earlier than serum creatinine,they were early sensitive markers;2.Urinary RBP could reflect the degree of cisplatin-induced acute kidney injury;3.The renal tubules was the chief target site of cisplatin-induced kidney injury.