Long‐term renal function in unilateral non‐syndromic renal tumor survivors treated according to International Society of Pediatric Oncology protocols

Schiavetti, Amalia; Altavista, Pierluigi; Luca, Laura De; Andreoli, G; Megaro, Giacomina; Versacci, Paolo

doi:10.1002/pbc.25558

Cited by 24 publications

(27 citation statements)

References 34 publications

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“…Long‐term survivors of Wilms' tumor are known to be at an increased risk for developing chronic renal insufficiency . In our study, the number of renal tumors was 214 in survivors of childhood and adolescent cancer and 101 for survivors of YA cancers equaling a total 315 renal tumors.…”

Section: Discussionmentioning

confidence: 69%

Diseases of renal function and bone metabolism after treatment for early onset cancer: A registry‐based study

Liuhto

Grönroos

Malila

et al. 2019

Intl Journal of Cancer

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Modern cancer therapy has led to a growing number of pediatric and young adult cancer survivors, who are prone to increased morbidities caused by the late effects of therapy. The aim of our study was to investigate pediatric and young adult cancer survivors' morbidity due to renal and bone metabolism diseases and especially to study bone metabolism in cancer survivors with renal disease. Patients were identified from the Finnish Cancer Registry, and the cohort consisted of 13,860, 5‐year survivors of cancer diagnosed below the age of 35 years. Healthy siblings were used as the comparison cohort. Information on the main outcomes was linked from the national Care Register for Health Care. Hazard ratios (HRs) comparing cancer survivors to siblings were calculated for various outcomes. The patient cohort was separated into two age groups, pediatric (0–19 years) and young adults (20–34 years). Significantly elevated HRs (p < 0.0001) in survivors were observed in both age groups for scoliosis (HR 1.6, 95% confidence interval [CI] 1.3–2.0), osteoporosis (HR 5.2, 95% CI 2.4–11.4), osteonecrosis (HR 12.7, 95% CI 5.4–29.7), nephritis (HR 1.9, 95% CI 1.5–2.2) and kidney failure (HR 3.6, 95% CI 2.4–5.3) for all. For cancer survivors with a renal outcome, the risk for developing any outcome of bone metabolism was increased (HR 2.3, 95% CI 1.4–3.6). These results show that pediatric and young adult cancer survivors have an elevated risk for long‐term, adverse outcomes related to renal function and bone metabolism. These results suggest follow‐up care for young cancer patients.

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Section: Discussionmentioning

confidence: 69%

Diseases of renal function and bone metabolism after treatment for early onset cancer: A registry‐based study

Liuhto

Grönroos

Malila

et al. 2019

Intl Journal of Cancer

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“…Increased albumin urine excretion (ACR > 30 mg/g) was observed in 7 TWs (13, 2%), 6 in the A2 category and 1 in the A3 category, risk category: G1A2 (moderately increased risk) -6, G2A2 (high risk) -1. Schiavetti et al examined 35 TWs and diagnosed CKD in 3 TWs, of G2A2 category (1) and G1A2 category (2), and detected signs of kidney damage on USG in 1 TWs [59].…”

Section: Discussionmentioning

confidence: 99%

Sonographic Image of Solitary Kidney in Wilms Tumour Survivors

Kosiak

Stefanowicz

Adamkiewicz-Drożyńska

et al. 2018

Kidney Blood Press Res

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Background/Aims: This study presents an analysis of the sonographic and laboratory parameters of solitary kidney in Wilms tumour survivors (TWs) and compares these parameters with those of healthy individuals. Methods: Fifty-three TWs who completed treatment for Wilms tumour and 44 healthy individuals were enrolled. The study protocol consisted of completing a medical history, sonographic examination of the solitary kidney, estimation of glomerular filtration rate (eGFR) by the Schwartz or MDRD formulas, albumin urine excretion and BP measurement. Results: Sonographic signs of kidney damage were observed in 22 (41,5%) TWs. The most frequently detected abnormalities are hyperechoic rings around renal pyramids (28,3% TWs). Hypertrophy of the solitary kidney occurred in 71,7% of cases. The mean volume of the solitary kidney was 77% of the sum of the two kidney volumes in the control group. The median eGFR in the TWs group was 117 with 25Q-105,5, 75Q-130 ml/min/1,73 m² vs 131,8 with 25Q-124, 75Q-140 ml/min/1,73 m² in the control group (p=0,000). Six TWs (11,3%) had a value of eGFR below 90 ml/min/1,73 m². Increased urine albumin excretion (> 30 mg/g) was observed in 7 TWs (13,2%) and in 3 (6,8%) individuals in the control group. Conclusion: Ultrasonographic abnormalities in solitary kidney of TWs are frequent. The most frequently detected abnormalities are hyperechoic rings around renal pyramids. Sonographic examination of TWs ought to be performed not only to detect tumour recurrence but also to assess the signs of kidney damage and their progression.

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“…A marker for CKD, which may be more sensitive to the detection of early renal impairment, is cystatin C. According to Kazama et al (41), a cystatin C serum concentration greater than 0.98 mg/dl has a sensitivity of 88.5% and a specificity of 95.2% for detecting GFR below 80 ml/min/1.73 m2. Recently, Schiavetti et al (42) evaluated the prevalence of and the possible risk factors for the renal impairment in 35 adult WTS by estimating GFR categories and CKD according to KDIGO guidelines from 2012 (6). Only eight (23%) survivors presented a mildly decreased eGFR, three survivors (9%) had CKD and one (3%) hypertension.…”

Section: %mentioning

confidence: 99%

Chronic Kidney Disease in Wilms Tumour Survivors – What Do We Know Today?

Stefanowicz

Kosiak

et al. 2016

Wilms Tumor

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Licence: This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Users are allowed to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material for any purpose, even commercially), as long as the authors and the publisher are explicitly identified and properly acknowledged as the original source. AbstractCurrently, the treatment of Wilms tumour (WT) is successful in approximately 90% of cases, and consists of chemotherapy, nephrectomy, and, in some cases, radiation therapy. All treatments have potential long-term influence on the function of solitary kidneys in WT survivors (WTS). Severe reduction in glomerular filtration rate occurs after nephrectomy. All patients who underwent surgical treatment for WT could be considered to have 132a risk of chronic kidney disease (CKD) because they lack a kidney. End-stage renal disease is rare (1.8% of National Wilms Tumour Study patients). Recent studies have revealed that patients with CKD have a greater risk of cardiovascular events and death. Most of the WTS have lower stages or no CKD. Regular biochemical studies and ultrasound examination at follow-up visits should be considered as indispensible elements of long-term care in uninephrectomized WTS. The evaluation of a single kidney function should be frequent, consisting of the assessment of estimated glomerular filtration rate (eGFR), assessment of albumin urine excretion, urine sediment analysis to detect abnormalities, ultrasound examination and measurements of blood pressure. According to Kidney Disease Improving Global Outcomes (KDIGO) recommendation and suggestions, GFR should be assessed using GFR-estimating equations that include serum creatinine and cystatin C concentrations. Cystatin C can be a more sensitive marker of kidney filtration function than creatinine, especially in diseases characterized by a mild decrease in glomerular filtration. This will facilitate the detection of early kidney impairment and assessment of the progression of CKD in WTS.

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Long‐term renal function in unilateral non‐syndromic renal tumor survivors treated according to International Society of Pediatric Oncology protocols

Cited by 24 publications

References 34 publications

Diseases of renal function and bone metabolism after treatment for early onset cancer: A registry‐based study

Diseases of renal function and bone metabolism after treatment for early onset cancer: A registry‐based study

Sonographic Image of Solitary Kidney in Wilms Tumour Survivors

Chronic Kidney Disease in Wilms Tumour Survivors – What Do We Know Today?

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