The Role of Neutrophil Gelatinase-Associated Lipocalin (NGAL) in the Early Detection of Nephrotoxicity caused by Chemotherapy for Breast Cancer

Abstract

Chemotherapy remains a cornerstone of breast cancer management; however, its potential to induce renal injury continues to pose substantial clinical challenges. Early identification of kidney impairment is essential to prevent irreversible damage and to maintain the safety and continuity of cancer treatment. Conventional indicators such as serum creatinine and estimated glomerular filtration rate (eGFR) lack sufficient sensitivity because they typically increase only after considerable nephron loss has occurred. Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a promising early biomarker for renal injury Synthesized by renal tubular epithelial cells and neutrophils in response to tissue damage, NGAL levels can rise within hours following exposure to nephrotoxic agents. This review examines the role of NGAL in detecting chemotherapy-related nephrotoxicity among breast cancer patients, drawing on evidence from both clinical and experimental studies. Post-chemotherapy elevations in NGAL frequently precede detectable changes in serum creatinine, highlighting its capacity to identify subclinical tubular injury. Nonetheless, additional prospective studies employing standardized measurement protocols are needed to further validate the diagnostic accuracy and clinical utility of NGAL.