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Late effects on renal glomerular and tubular function in childhood cancer survivors
Author(s) -
Bárdi Edit,
Oláh Anna V.,
Bartyik Katalin,
Endreffy Emőke,
Jenei Csaba,
Kappelmayer János,
Kiss Csongor
Publication year - 2004
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20143
Subject(s) - medicine , proteinuria , microalbuminuria , renal function , nephrotoxicity , wilms' tumor , urinary system , cystatin c , nephropathy , urology , population , endocrinology , gastroenterology , kidney , diabetes mellitus , environmental health
Background Late nephrotoxicity among childhood cancer survivors is poorly documented. Methods We investigated 115 patients and 86 controls assessing serum cystatin C concentration (CysC), urinary N ‐acetyl‐β‐ d ‐glucosaminidase activity (NAG), and microalbuminuria. Protenuria was quantified and electrophoresis performed. Polymorphism of the angiotensin convertase enzyme ( ACE ) gene was determined by genomic PCR. Results CysC was elevated in Wilms tumor (WT) patients. Gross proteinuria was observed in 30 patients including three patients with progressive proteinuria who improved on ACE‐inhibitor treatment. Neither patients with proteinuria nor the entire study population differed from controls with respect to ACE polymorphism. Pathologically elevated urinary NAG was noted in 38% of leukemia/lymphoma, 54% of solid tumor, 20% of WT survivors. A similar distribution of pathological microalbuminuria was found. Conclusions Mild‐to‐moderate subclinical glomerular and tubular damage can be identified in many childhood cancer survivors. However, most patients experience some spontaneous recovery from acute nephrotoxicity. © 2004 Wiley‐Liss, Inc.