Acute kidney injury (AKI) limits cisplatin use. We tested whether urine cystatin C (uCyC) and neutrophil gelatinase‐associated lipocalin (uNGAL) can preidentify patients at risk for AKI. Patients initiating cisplatin‐based chemotherapy were prospectively enrolled. uNGAL/uCyC were measured pre/post‐cisplatin administration and compared with serum creatinine (sCr). AKI was defined as sCr increase ≥50% or ≥0.3 mg/dL above baseline. In all, 102 patients were enrolled; 95 provided evaluable data. Twenty‐five patients developed AKI. Median baseline and pre‐cisplatin uNGAL levels were significantly higher in AKI patients. Although immediate changes in uNGAL/uCyC 2 h after cisplatin were not detectable, post‐cisplatin peak values over the course of therapy were markedly and significantly elevated in AKI patients. In multivariate modeling with age, baseline glomerular filtration rate, and histology, maximum uCyC was a significant independent AKI predictor. These findings suggest pre‐cisplatin uNGAL and peak uCyC levels can identify patients with increased AKI risk, potentially allowing for tailored modification of cisplatin‐based treatment regimens.
This study deepens the field's understanding about factors that contribute to positive social engagement between students without disabilities and their peers with mild disabilities in general education classrooms. A sample of 68 seventh grade students with and without disabilities was drawn from general education classrooms in a suburban, Midwest district in the United States. Direct observation of students' social behavior, as well as student surveys and context measures, were used to explore associations among student attitudes, their perceived norms, feelings of efficacy, stated intentions and their actions towards peers with disabilities. Results revealed that students without disabilities strong intentions to interact with peers with disabilities were unrelated to their actual behavior. However, students' attitudes, norms, and feelings of efficacy were predictive of their intentions. Interpretations and implications for understanding the interplay of predisposing factors, intentions to socialize, and actual socializing behavior are discussed.
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