Time-dependent changes in kidney injury biomarkers in patients receiving multiple cycles of cisplatin chemotherapy.

Proteins secreted into urine following tubular injury are being increasingly used as biomarkers of clinical and subclinical nephrotoxicity. In the present study, we sought to characterize the time-dependent urinary excretion of three promising biomarkers, kidney injury molecule-1 (KIM-1), calbindin, and trefoil factor 3 (TFF3), during two different chemotherapy cycles in 27 patients with solid tumors prescribed the anticancer drug cisplatin (≥25 mg/m). Urinary biomarkers were evaluated at Days 3 and 10 during an initial and a subsequent cycle of cisplatin chemotherapy.

Pharmacokinetic determinants of cisplatin-induced subclinical kidney injury in oncology patients.

Purpose: The ability to predict and detect clinical and subclinical nephrotoxicity early in the course of therapy has the potential to improve long-term outcomes in cancer patients receiving cisplatin chemotherapy. Pharmacokinetic parameters could serve as predictors of cisplatin-induced nephrotoxicity.

Methods: Participants [n = 13] were treated with a 1-h cisplatin infusion [30-75 mg/m].

Pharmacogenomic Variants May Influence the Urinary Excretion of Novel Kidney Injury Biomarkers in Patients Receiving Cisplatin.

Nephrotoxicity is a dose limiting side effect associated with the use of cisplatin in the treatment of solid tumors. The degree of nephrotoxicity is dictated by the selective accumulation of cisplatin in renal tubule cells due to: (1) uptake by organic cation transporter 2 (OCT2) and copper transporter 1 (CTR1); (2) metabolism by glutathione S-transferases (GSTs) and γ-glutamyltransferase 1 (GGT1); and (3) efflux by multidrug resistance-associated protein 2 (MRP2) and multidrug and toxin extrusion protein 1 (MATE1). The purpose of this study was to determine the significance of single nucleotide polymorphisms that regulate the expression and function of transporters and metabolism genes implicated in development of acute kidney injury (AKI) in cisplatin treated patients.

Profiling of Kidney Injury Biomarkers in Patients Receiving Cisplatin: Time-dependent Changes in the Absence of Clinical Nephrotoxicity.

The success of cisplatin-containing regimens to treat solid tumors is limited, in part, by nephrotoxicity. In rodents, several urinary proteins have emerged that are sensitive indicators of cisplatin-induced kidney injury. We sought to characterize time-dependent changes in the urinary concentrations of 12 proteins, including kidney injury molecule-1 (KIM-1), calbindin, beta 2-microglobulin (β2M), and trefoil factor 3 (TFF3) after cisplatin therapy.

Psychotherapeutic home intervention program: impact on Medicaid readmission rates.

Records of 52 Medicaid managed care psychiatric patients engaged in a home intervention program (HIP) were analyzed to determine (a) if home-based intervention reduced a participant's readmission rates to an inpatient behavioral health facility and (b) if a negative relationship existed between total HIP sessions and readmissions following the implementation of home-based services. A paired t test comparing admissions 6 months prior to HIP with admissions 6 months after HIP demonstrated an average decrease of readmissions by 2.5 (p < .

Reforming managed care certification of mental health services.

This article examines the issues associated with the current managed care delivery system for certification of mental health services, including pain management. Inconsistencies in dispositions having impacts upon patient care appear to be inherent in the current peer review certification system. Issues related to public assistance clients will be given particular attention.