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Long‐term renal function in unilateral non‐syndromic renal tumor survivors treated according to International Society of Pediatric Oncology protocols
Author(s) -
Schiavetti Amalia,
Altavista Pierluigi,
De Luca Laura,
Andreoli Gianmarco,
Megaro Giacomina,
Versacci Paolo
Publication year - 2015
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.25558
Subject(s) - medicine , pediatric oncology , renal function , term (time) , renal tumor , oncology , pediatrics , kidney , nephrectomy , cancer , physics , quantum mechanics
Background The risk of renal impairment among survivors of childhood unilateral non‐syndromic renal tumors (RTs) is not well defined. We evaluated the prevalence of and possible risk factors for renal impairment by estimating Glomerular Filtration Rate (eGFR) categories and chronic kidney disease (CKD) according to Kidney Disease: Improving Global Outcomes guidelines. Procedure Since 1978, 82 patients were treated for RT, according to the International Society of Pediatric Oncology protocols in a single oncology unit. Of the 67 survivors, those who underwent nephron sparing surgery, those with short‐term follow‐up or those who had bilateral and/or syndromic disease or a second malignancy were excluded. Thirty‐five adult survivors ( 14 M/21F; mean age 25 years; mean follow‐up 20 years) were studied by chemistry, kidney ultrasound, blood pressure measurement, urinanalysis. Correlations were investigated between the prevalence of eGFR categories and CKD and gender, age at diagnosis, radiotherapy, chemotherapy, body mass index, time of follow‐up, and age at study. Results Eight (22.9%) survivors presented a mildly decreased eGFR (G2 category), the mean value was 80 ± 9.78 ml/min/1.73m 2 ( median 84.5, range 63–89). Three (8.6%) survivors had CKD and a fourth (2.9%) hypertension. No significant correlations between G2 category and clinical variables were found. Conclusions A small percentage of survivors had CKD or hypertension after two decades. It is not yet clear whether a mildly decreased eGFR that does not constitute CKD in the absence of other markers (albuminuria and/or kidney ultrasound abnormalities) is likely to progress to CKD. Health promotion programs to avoid comorbidities are required. Pediatr Blood Cancer 2015;62:1637–1644. © 2015 Wiley Periodicals, Inc.