Diagnostic Accuracy of Serum Neutrophil Gelatinase-Associated Lipocalin versus Serum Creatinine for Early Identification of Cisplatin-Induced Acute Kidney Injury

International Journal of Medicine and Medical Sciences | Vol. 15, No. 6, June 2025 | pp. 41–48

DOI: 10.46882/2025/IJMMS/150041

Original Research Article

Diagnostic Accuracy of Serum Neutrophil Gelatinase-Associated Lipocalin versus Serum Creatinine for Early Identification of Cisplatin-Induced Acute Kidney Injury

Charles O. Igwe¹, Rachel L. Sanon², Anthony D. Boateng¹*

¹Department of Oncology, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria.

²Department of Nephrology, Faculty of Health Sciences, Université de Ouagadougou, Ouagadougou, Burkina Faso.

Abstract:

The clinical utility of the chemotherapy drug cisplatin is limited by dose-dependent nephrotoxicity, which often goes undetected by slow rises in traditional serum creatinine. This prospective cohort study evaluated the diagnostic accuracy of serum neutrophil gelatinase-associated lipocalin (sNGAL) for early identification of cisplatin-induced acute kidney injury (AKI). We evaluated 130 adult cancer patients with normal baseline renal function who were scheduled to receive high-dose cisplatin therapy (≥ 70 mg/m²). Serum NGAL was measured via chemiluminescent immunoassay at baseline, 6, 12, and 24 hours post-infusion, while serum creatinine was monitored daily for 7 days. AKI was defined according to the KDIGO serum creatinine criteria. Twenty-eight patients developed confirmed AKI (21.5%) within 72 hours. In the AKI group, sNGAL levels rose significantly from a baseline of 78.5 ± 12.4 ng/mL to 184.2 ± 24.6 ng/mL at 12 hours post-cisplatin infusion (p < 0.01), whereas serum creatinine variations were non-significant at this time point. Receiver Operating Characteristic (ROC) analysis showed that 12-hour sNGAL at a cutoff value of 135 ng/mL had a sensitivity of 89.3%, a specificity of 84.3%, and an Area Under the Curve (AUC) of 0.91 (95% CI = 0.84–0.96). In contrast, 24-hour serum creatinine achieved an AUC of only 0.64. Serum NGAL serves as a sensitive and precise early diagnostic biomarker for cisplatin-induced tubular injury, allowing for early optimization of hydration protocols and potential chemotherapy dosage adjustments before structural renal function declines.

Keywords: Cisplatin, Nephrotoxicity, Acute Kidney Injury, Neutrophil Gelatinase-Associated Lipocalin, Biomarkers, Chemotherapy

Manuscript Timeline: Received: March 14, 2025; Revised: April 22, 2025; Accepted: May 15, 2025; Published: June 16, 2025.

Citation: Igwe CO, Sanon RL, Boateng AD. Diagnostic Accuracy of Serum Neutrophil Gelatinase-Associated Lipocalin versus Serum Creatinine for Early Identification of Cisplatin-Induced Acute Kidney Injury. International Journal of Medicine and Medical Sciences, 2025, 15(6): 41–48. DOI: 10.46882/2025/IJMMS/150041

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