The significance of enzymuria in assessing the nephrotoxicity of antitumor chemotherapy in children

The significance of enzymuria in assessing the nephrotoxicity of cisplatin in a total dose of 100 mg/m2 or iphosphamide in a total dose of 9 g/m2 for children with solid malignant tumors (10 and 9 patients, respectively) was studied. Chemotherapy caused stable hyper-enzymuria consisting in a significant increase in N-acetyl-β-d-hexosaminidase, γ-glutamyltransferase, and alanine aminopeptidase activities in the urine during chemotherapy in comparison with the initial values. The levels of enzyme excretion with the urine were higher in patients treated with iphosphamide than in those treated with cisplatin. The increase in serum creatinine and urea concentrationsvs. the age-specific norm was observed in only 2 out of 9 children treated with iphosphamide. These results permit considering enzymuria as the most sensitive method for the diagnosis of nephrotoxicity.