Utility of Monitoring Renin And Aldosterone Levels In Determining Efficacy  of Chemotherapy

Sajjad Ali Haider; Zujaja Hina Haroon; Athar Iqbal Paracha; Afshan Bibi; Muhammad Wasi Nayyar; Uzma Ansari

doi:10.51253/pafmj.v75i5.9143

Authors

Sajjad Ali Haider Department of Chemical Pathology, Armed Forces Institute of Pathology Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Zujaja Hina Haroon Department of Chemical Pathology, Armed Forces Institute of Pathology Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Athar Iqbal Paracha Department of Chemical Pathology, Armed Forces Institute of Pathology Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Afshan Bibi Department of Chemical Pathology, Armed Forces Institute of Pathology Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Muhammad Wasi Nayyar Department of Chemical Pathology, Armed Forces Institute of Pathology Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Uzma Ansari Department of Chemical Pathology, Pakistan Navy Station Shifa Hospital Karachi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i5.9143

Keywords:

Aldosterone, Angiotensin-Converting Enzyme Inhibitors, Anthracyclines, Brain Natriuretic Peptide, Renin

Abstract

Objective: To determine the clinical utility of renin and aldosterone levels in cancer patients treated with combination of ACE inhibitors and anthracyclines

Study Design: Quasi-experimental study

Place and Duration of Study: Department of Chemical Pathology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan, from Jul to Dec 2020.

Methodology: Patients of either gender, aged between 40-70 years, who were diagnosed with various malignancies and were on anthracyclines as part of chemotherapy for last six months were enrolled and further divided into two groups. Group I patients were given anthracyclines alone, Group II patients were given ACE (Angiotensin-Converting Enzyme) inhibitors along with anthracyclines. Samples were collected and analyzed for Active Renin Concentration (ARC), plasma aldosterone, troponin I and N-terminal pro-B-type natriuretic (NT-proBNP) peptide. Mean values of these parameters amongst two groups were compared by applying independent sample t test where p-value ≤ 0.05 was considered as significant.

Results: Out of 195 patients 114(58.5%) were in Group I and 81(41.5%) were in Group II. Mean values of plasma aldosterone (799.84 ± 56.88 pmol/L vs 430.59±62.36 pmol/L), ARR (Aldosterone-to-Renin Ratio) (46.24±21.80 pmol/mIU vs 25.77±7.10 pmol/mIU), Pro BNP (125.26±10.61 pg/ml vs 87.77 ± 8.76 pg/ml) and trop I (0.06±0.011 ng/ml vs 0.04±0.007 ng/ml) were higher in Group I as compared to Group II. The difference among means of each parameter amongst two groups was found to be statically significant (p-value≤ 0.05).

Conclusion: Plasma aldosterone, ARR, Trop I and NT pro BNP levels can be used for monitoring and early detection of Anthracycline-Induced Cardiomyopathy (AIC).

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