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Kidney Week

Abstract: FR-PO008

Cisplatin-Induced Kidney Injury Is Transient and Associated with Short-Term Elevation of Urine Interleukin-18 in Patients with Testicular Cancer

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials


  • McMahon, Kelly, McGill University, Montreal, Quebec, Canada
  • Cameron, Alan C., University of Glasgow, Glasgow, United Kingdom
  • White, Jeff D., Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
  • Welsh, Paul, University of Glasgow, Glasgow, United Kingdom
  • Zappitelli, Michael, Toronto Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
  • Touyz, Rhian, University of Glasgow, Glasgow, United Kingdom
  • Mark, Patrick B., University of Glasgow, Glasgow, United Kingdom
  • Lang, Ninian N., University of Glasgow, Glasgow, United Kingdom

Cisplatin causes acute kidney injury (AKI) but changes in urinary AKI biomarkers are not well defined in clinical practice. We investigated short- and medium-term AKI using novel biomarkers over 9 months in patients with testicular cancer treated with cisplatin.


Prospective observational study of men with testicular cancer in 3 groups following orchiectomy: 1) surveillance; 2) adjuvant cisplatin (1-2 cycles); 3) metastatic disease with high dose cisplatin (3-4 cycles). Blood/urine was collected at 6 visits: baseline, 24h, 6 weeks, 3, 6 and 9 months for renal injury markers.


27 men (median age 34y [IQR 31-40y]) were recruited: surveillance (N=10); adjuvant cisplatin (N=7); metastatic cisplatin (N=10). Urine tubular injury markers (interleukin-18 [IL-18], neutrophil gelatinase-associated lipocalin [NGAL], vascular endothelial growth factor [VEGF], kidney injury molecule-1 [KIM-1]), urine albumin/creatinine ratio (ACR) and serum cystatin C (CysC) were elevated at 24h and 6 weeks (KIM-1) post cisplatin in adjuvant and metastatic groups (all: P<0.05 vs. baseline). These normalized by 6 weeks (IL-18, NGAL, VEGF, ACR, CysC) and 3 months (KIM-1). eGFR was within normal range throughout. Urine IL-18 rose in both cisplatin groups at 24h (median [IQR]: adjuvant 24h 22.8 [16.4-34.7] vs. baseline 6.8 [5.7-15.9]; metastatic 24h 23.7 [20.1-36.1] vs. baseline 9.2 [7.2-11.9] pg/mg, P<0.05) and returned to baseline by 6 weeks.


Cisplatin nephrotoxicity is reversible over 3 months and is evident with use of novel biomarkers. Elevation of IL-18 supports a major inflammatory renal insult. This provides evidence to support investigation of anti-inflammatory drugs to prevent cisplatin toxicity.


  • Government Support - Non-U.S.