Assessing the hepatic and renal parameters of breast cancer patient blood samples before and after chemotherapy

Breast cancer (BC) is the most common malignancy in women, with chemotherapy as a fundamental treatment despite its potential to cause hepatotoxicity and nephrotoxicity. Although routine assessment of organ function is customary, the predictive value of composite liver-kidney biomarkers for post-chemotherapy survival remains inadequately investigated. This retrospective study sought to assess the influence of chemotherapy on hepatic and renal parameters in 132 BC patients treated at King Abdullah University Hospital (KAUH) in Jordan from January 2011 to April 2025, with a particular focus on the prognostic relevance of the Albumin-Creatinine Ratio (ACR), Alkaline Phosphatase-to-Creatinine Ratio (ALP/Cr), and Albumin-Bilirubin (ALBI) score. Liver and kidney function tests were evaluated pre- and post-four chemotherapy cycles utilizing Wilcoxon signed-rank tests, Kaplan-Meier survival curves, and Cox proportional hazards regression. Post-treatment analysis demonstrated a moderate yet statistically significant reduction in total protein (p = 0.035) and serum creatinine (p = 0.019). Significantly, whereas routine enzymes (ALT, AST, ALP) exhibited no notable alterations, the composite biomarkers ACR and ALP/Cr ratio demonstrated substantial increases post-treatment (p = 0.036 and p = 0.030, respectively). Using ROC-derived cut-offs, the survival analysis revealed that patients with a low post-treatment ACR (<1045) had significantly longer overall survival (OS) than those in the high-ACR group (8.14 vs. 2.35 years; p = 0.009). Further, a lower post-treatment ALP/Cr ratio (<1491.7) was associated with longer survival (8.94 vs. 6.12 years; p = 0.017). These data suggest that, whereas individual liver and kidney indicators were relatively stable, composite biomarkers-specifically ACR and ALP/Cr-were more susceptible to treatment-induced physiological stress. Thus, these ratios serve as crucial indicators of OS, suggesting that incorporating hepatic and renal evaluations into composite markers provides greater predictive value for monitoring BC patients than standalone organ function tests.