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Yield of Urinalysis Screening in Pediatric Cancer Survivors
Author(s) -
Ramirez Matthew D.,
Mertens Ann C.,
Esiashvili Natia,
Meacham Lillian R.,
WasilewskiMasker Karen
Publication year - 2016
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.25897
Subject(s) - medicine , urinalysis , population , cancer , pediatrics , urinary system , environmental health
Background The Children's Oncology Group (COG) publishes consensus guidelines with screening recommendations for early identification of treatment‐related morbidities among childhood cancer survivors. We sought to estimate the yield of recommended yearly urinalysis screening for genitourinary complications as per Version 3.0 of the COG Long‐Term Follow‐Up Guidelines and identify possible risk factors for abnormal screening in a survivor population. Procedure A database of pediatric cancer survivors evaluated between January 2008 and March 2012 at Children's Healthcare of Atlanta was queried for survivors at risk for genitourinary late effects. The frequency of abnormal urinalyses (protein ≥1+ and/or presence of glucose and/or ≥5 red blood cells per high power field) was estimated. Risk factors associated with abnormal screening were identified. Results Chart review identified 773 survivors (57% male; 67% Caucasian; 60% leukemia/lymphoma survivors; mean age at diagnosis, 5.7 years [range: birth to 17.7 years]; time from diagnosis to initial screening, 7.6 years [range: 2.3 to 21.5 years]) who underwent urinalysis. Abnormal results were found in 78 (5.3%) of 1,484 total urinalyses. Multivariable analysis revealed higher dose ifosfamide (odds ratio [OR] = 6.8, 95% confidence interval [CI] 2.9–16.0) and total body irradiation (TBI, OR = 3.0, 95% CI 1.0–8.4) as significant risk factors for abnormal initial urinalysis screening. Conclusions Pediatric cancer survivors exposed to higher dose ifosfamide or TBI may be at higher risk of abnormal findings on urinalysis screening. Targeted screening of these higher risk patients should be considered.