Urinary Beta-2-Microglobulin and Late Nephrotoxicity in Childhood Cancer Survivors

Abstract

The objectives of this study were to evaluate urinary beta-2-microglobulin (β2M) levels in long-term childhood cancer survivors and to establish its association with anticancer drug-induced nephrotoxicity. The study consisted of 165 childhood cancer survivors (CCS) who were in continuous complete remission. We reported that CCS had a significantly higher level of β2M (p < 0.001) and β2M/Cr. ratio (p < 0.05) than healthy peers. Among all participants, 24 (14.5%) had decreased eGFR (<90 mL/min/1.73 m2). A significant positive correlation between β2M/Cr. ratio and body mass index (coef. 14.48, p = 0.046) was found. Furthermore, higher levels of urinary β2M were detected among CCS with a longer follow-up time (over 5 years) after treatment. Subjects with decreased eGFR showed statistically higher urinary β2M levels (20.06 ± 21.56 ng/mL vs. 8.55 ± 3.65 ng/mL, p = 0.007) compared with the healthy peers. Twelve survivors (7.2%) presented hyperfiltration and they had higher urinary β2M levels than CCS with normal glomerular filtration (46.33 ± 93.11 vs. 8.55 ± 3.65 ng/mL, p = 0.029). This study did not reveal an association between potential treatment-related risk factors such as chemotherapy, surgery, radiotherapy, and the urinary β2M level. The relationship between treatment with abdominal radiotherapy and reduced eGFR was confirmed (p < 0.05). We demonstrated that urinary beta-2-microglobulin may play a role in the subtle kidney injury in childhood cancer survivors; however, the treatment-related factors affecting the β2M level remain unknown. Further prospective studies with a longer follow-up time are needed to confirm the utility of urinary β2M and its role as a non-invasive biomarker of renal dysfunction.

Recent Advances of Proteomics in Management of Acute Kidney Injury

“…Lately, sTNFR1 and sTNFR2 as circulating plasma biomarkers were assessed to investigate the potential to stratify patients who are at low or high risk for CKD progression after 3 years of hospitalization during AKI onset. Associations between biomarkers and kidney disease progression were evaluated in 500 patients using multivariable logistic regression models [ 22 ]. Although sTNFR1 and sTNFR2 have been observed to be related to AKI pathophysiology, they are not specific AKI biomarkers, and therefore more validation studies are needed to prove their clinical utility.…”

Circulating Levels of Soluble α-Klotho and FGF23 in Childhood Cancer Survivors: Lack of Association with Nephro- and Cardiotoxicity—A Preliminary Study

“…In recent times, endeavors have been undertaken to discern cancer survivors who exhibit susceptibility to kidney failure several years after cancer treatment. Currently, new markers of kidney damage are being sought that can herald kidney damage even before symptoms appear [17,18].…”