Renal function in children treated for central nervous system malignancies

Musioł, Katarzyna; Sobol‐Milejska, Grażyna; Nowotka, Łukasz; Torba, Karolina; Kniażewska, Maria; Woś, Halina

doi:10.1007/s00381-016-3130-2

Cited by 8 publications

(4 citation statements)

References 51 publications

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“…However, conclusions from this analysis should be drawn with caution due to the very small sample size. Another study carried out in children previously treated for central nervous system malignancy showed negative correlation between β2M level and eGFR [26]. However, we did not confirm this finding.…”

Section: Discussioncontrasting

confidence: 94%

Urinary Beta-2-Microglobulin and Late Nephrotoxicity in Childhood Cancer Survivors

Latoch

Konończuk

Taranta-Janusz

et al. 2021

JCM

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The objectives of this study were to evaluate urinary beta-2-microglobulin (β2M) levels in long-term childhood cancer survivors and to establish its association with anticancer drug-induced nephrotoxicity. The study consisted of 165 childhood cancer survivors (CCS) who were in continuous complete remission. We reported that CCS had a significantly higher level of β2M (p < 0.001) and β2M/Cr. ratio (p < 0.05) than healthy peers. Among all participants, 24 (14.5%) had decreased eGFR (<90 mL/min/1.73 m2). A significant positive correlation between β2M/Cr. ratio and body mass index (coef. 14.48, p = 0.046) was found. Furthermore, higher levels of urinary β2M were detected among CCS with a longer follow-up time (over 5 years) after treatment. Subjects with decreased eGFR showed statistically higher urinary β2M levels (20.06 ± 21.56 ng/mL vs. 8.55 ± 3.65 ng/mL, p = 0.007) compared with the healthy peers. Twelve survivors (7.2%) presented hyperfiltration and they had higher urinary β2M levels than CCS with normal glomerular filtration (46.33 ± 93.11 vs. 8.55 ± 3.65 ng/mL, p = 0.029). This study did not reveal an association between potential treatment-related risk factors such as chemotherapy, surgery, radiotherapy, and the urinary β2M level. The relationship between treatment with abdominal radiotherapy and reduced eGFR was confirmed (p < 0.05). We demonstrated that urinary beta-2-microglobulin may play a role in the subtle kidney injury in childhood cancer survivors; however, the treatment-related factors affecting the β2M level remain unknown. Further prospective studies with a longer follow-up time are needed to confirm the utility of urinary β2M and its role as a non-invasive biomarker of renal dysfunction.

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Section: Discussioncontrasting

confidence: 94%

Urinary Beta-2-Microglobulin and Late Nephrotoxicity in Childhood Cancer Survivors

Latoch

Konończuk

Taranta-Janusz

et al. 2021

JCM

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“…Childhood cancer survivors are at a particular risk of developing adverse effects caused by multimodal treatment for their malignancy 6 . Studies that have assessed hypomagnesemia in cancer survivors determined a prevalence ranging between 13.2% and 28.6% [7][8][9][10] .…”

Section: Epidemiology and Clinical Outcomesmentioning

confidence: 99%

Hypomagnesemia in the Cancer Patient

et al. 2021

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Hypomagnesemia is a common medical problem that contributes to the morbidity and mortality of cancer patients. This review summarizes magnesium physiology and highlights the mechanisms underlying magnesium disturbances due to cancer and cancer treatment. The causes of hypomagnesemia can be categorized by the pathophysiological mechanism: decreased intake, transcellular shift, gastrointestinal losses, and kidney losses. Cancer patients are at risk for opportunistic infections, frequently experience cardiovascular complications, and often receive classes of medications that cause or exacerbate hypomagnesemia. Also, cancer-specific therapies are responsible for hypomagnesemia, including platinum-based chemotherapy, anti-EGFR monoclonal antibodies, human epidermal growth factor receptor-2 target inhibitors(HER2), and calcineurin inhibitors. Urinary indices, such as the fractional excretion of magnesium, can provide useful information about the etiology. The management of hypomagnesemia depends on the magnitude of hypomagnesemia and the underlying cause. We recommended checking serum magnesium at the beginning of treatment and as part of routine monitoring throughout cancer treatment. Opportunities exist for potential research and practice improvement, including further characterization of hypomagnesemia on the clinical impact on cancer outcomes, preventing hypomagnesemia in patients receiving high-risk anti-cancer agents, and developing effective therapeutic strategies.

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“…Although serum B2M has been used as a tool for evaluation of kidney function in pediatric populations with malignancy in research settings [173], it is unclear whether there are added benefits of B2M compared to other markers in these specific pediatric populations.…”

Section: Considerations Regarding the Use In Childrenmentioning

confidence: 99%

Endogenous markers for kidney function in children: a review

Bakker

Gemke

Bökenkamp

2018

Critical Reviews in Clinical Laboratory Sciences

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Although glomerular filtration rate (GFR) in children can be measured using a gold-standard technique following injection of an exogenous marker, this invasive and cumbersome technique is not widely available and GFR is commonly estimated using serum levels of endogenous markers. Creatinine, urea, cystatin C, beta-trace protein, and beta-2 microglobulin are well-established endogenous markers of kidney function. These markers differ in site of production and effects of diet and medication, as well as renal-tubular handling and extra-renal elimination. For each marker, different methods are available for measurement. Importantly, the measurements of creatinine and cystatin C have recently been standardized with the introduction of international reference standards. In order to allow estimation of GFR from serum marker concentrations, different equations for estimated GFR (eGFR) have been developed in children, using simple or more complex regression strategies with gold standard GFR measurements as a dependent variable. As a rule, estimation strategies relying on more than one marker - either by calculating the average of single parameter equations or by using more complex equations incorporating several parameters - outperform eGFR estimations using only a single marker. This in-depth review will discuss the physiology, measurement and clinical use of creatinine, urea, cystatin C, beta-trace protein, and beta-2 microglobulin in children. It will also address the generation of eGFR equations in children and provide an overview of currently available eGFR equations for the pediatric age group.

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Renal function in children treated for central nervous system malignancies

Cited by 8 publications

References 51 publications

Urinary Beta-2-Microglobulin and Late Nephrotoxicity in Childhood Cancer Survivors

Urinary Beta-2-Microglobulin and Late Nephrotoxicity in Childhood Cancer Survivors

Hypomagnesemia in the Cancer Patient

Endogenous markers for kidney function in children: a review

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