Longitudinal cohort links chemotherapy cycles with shifting liver, kidney and electrolyte markers in 60 Kenyan cervical cancer patients

A longitudinal cohort study of 60 patients with cervical cancer receiving chemotherapy at Jaramogi Oginga Odinga Teaching and Referral Hospital in Western Kenya found that kidney-function markers changed from the first treatment cycle, while shifts in several liver-associated enzymes and a decline in serum sodium emerged in later cycles. These findings are reported in the abstract of an open-access BMC Cancer article published on 18 September 2026; the abstract notes that the displayed version may still undergo further edits before the final Version of Record.

The researchers enrolled patients aged 23–80 years between September 2024 and February 2025. Venous blood samples were collected at baseline and at three subsequent 21-day chemotherapy-cycle intervals. They measured alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and gamma-glutamyl transferase as liver-associated enzymes; urea, creatinine and estimated glomerular filtration rate as kidney-function markers; and sodium, potassium and chloride as serum electrolytes. All measurements were made with the Cobas Integra 400 Plus chemistry analyzer. According to the abstract, Shapiro–Wilk testing indicated non-normal data distributions, so the investigators used Friedman tests for overall longitudinal comparisons. Follow-up comparisons applied a Bonferroni–Holm correction for liver enzymes and a Bonferroni correction for kidney and electrolyte parameters, with significance set at p < 0.05.

Kidney-related measurements showed the earliest changes. Serum creatinine increased significantly from the first cycle onward (Friedman χ² = 28.918, p < 0.001), while estimated glomerular filtration rate declined significantly after the first cycle (χ² = 27.438, p < 0.001). Urea rose significantly by the third cycle (χ² = 7.841, p = 0.049). Serum sodium also declined progressively: the group mean fell from 135.2 ± 4.2 mmol/L at baseline to 131.5 ± 12.2 mmol/L by the third cycle. The overall sodium change was significant from the second cycle onward (χ² = 22.151, p < 0.001), and the group mean was below the study’s stated 135–145 mmol/L reference range by cycle two. Potassium and chloride did not change significantly during treatment, with p-values of 0.881 and 0.333, respectively.

Changes in liver-associated enzymes varied by marker. Alanine aminotransferase and aspartate aminotransferase were significantly elevated in the later cycles, with Friedman statistics of χ² = 17.428 and χ² = 12.898, respectively. Alkaline phosphatase increased progressively from the second cycle onward (χ² = 25.823, p < 0.0001), whereas gamma-glutamyl transferase showed no statistically significant change (p = 0.299). The abstract reports temporal associations within a treated cohort of 60 patients at one hospital. It does not describe an untreated or otherwise unexposed comparison group, so the findings do not establish that chemotherapy caused the observed changes. The abstract also does not report the chemotherapy regimens, clinical outcomes, direct measures of kidney or liver injury, completeness of follow-up or potential confounding factors. The single-center sample and these omitted details limit interpretation and do not show how broadly the results might apply beyond the hospital studied.

Subject of Research: Longitudinal changes in liver, kidney and electrolyte biomarkers during chemotherapy for cervical cancer in Kenya

Article Title: Biochemical changes in liver, kidney, and electrolyte parameters among cervical cancer patients receiving chemotherapy in a kenyan referral hospital

Article References: Ogutu, E. A., Owuor, B., & Nonoh, J. (2026). Biochemical changes in liver, kidney, and electrolyte parameters among cervical cancer patients receiving chemotherapy in a kenyan referral hospital. BMC Cancer. https://doi.org/10.1186/s12885-026-16848-9

Image Credits: AI Generated

DOI: 10.1186/s12885-026-16848-9

Keywords: cervical cancer, chemotherapy, liver enzymes, kidney function, serum electrolytes, creatinine, estimated glomerular filtration rate, sodium, longitudinal cohort, Kenya, Biochemical, changes